Social determinants of health explored within an electronic patient reported outcomes (ePROs) remote symptom monitoring platform for patients with acute myeloid leukemia (AML).

Authors

null

Omer Hassan Jamy

Department of Medicine, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL

Omer Hassan Jamy, Tanya Marya Wildes, Nicholas C Coombs, Emily R Beamon, Fjoralba Kristo, Dasha Cherepanov, Aaron Galaznik, Emelly Rusli

Organizations

Department of Medicine, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, University of Nebraska Medical Center, Omaha, NE, Piedmont Research Strategies, Inc, Greenville, NC, Takeda, Cambridge, MA, Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, Carevive Systems Inc., Miami, FL, Carevive Systems Inc., North Miami, FL

Research Funding

No funding received
None.

Background: Social determinants of health (SDoH) are non-medical factors, such as income, education, employment, and area of residence that can influence health outcomes. Research shows SDoH impact people’s health, well-being, and quality of life (QoL) and, for patients with cancer, treatment outcomes. Electronic Patient Reported Outcomes (ePROs) integration into routine oncology practice improves patient time on therapy, survival, and resource utilization. This study explores the use of an ePRO platform for routine gathering of SDoH into care for Acute Myeloid Leukemia (AML). Methods: Adult patients with AML undergoing treatment were enrolled in the Carevive remote symptom monitoring (RSM) platform between March 1, 2021 and April 20, 2023. Patients received baseline and weekly surveys to assess symptom burden, physical function, and overall health throughout treatment. Baseline characteristics included age, sex, race, frailty status (modified Geriatric Assessment, CARE survey item, and/or self-reported activity level), comorbidities, and SDoH (living-, caregiver-, marital-, employment-, education-, insurance-status, travel distance to cancer center. Symptoms (derived from the PRO-CTCAE) and QoL (EORTC QLC C30 #29 & #30) were assessed weekly, along with survey compliance. Results were stratified by SDoH status and compared by symptom burden and QoL. Results: 124 patients were included in analysis, with median follow-up time of 12 weeks. Half were male (50%); median age was 66 (range 21-88), majority were White (76%) and had at least one comorbidity (69%). Survey compliance was 69%, measured by total number of surveys completed out of total number of surveys assigned by each patient. Among the 71 (57%) who completed all SDoH responses, 38 (54%) were married, 35 (49%) had at least a bachelor’s degree, 45 (63%) were retired, 45 (63%) reported having a full- or part-time caregiver, 26 (37%) lived with at least one other adult, and 48 (68%) lived more than 20 miles from their nearest cancer center. Patients living with at least one other adult reported symptoms more often than patients living alone (1.65 vs. 1.24 total symptoms per patient-week). Symptom reporting was comparable across all other SDoH responses. Conclusions: This study illustrates feasibility of using RSM for gathering SDoH indicators in routine care. While overall survey compliance was high, 43% did not complete all SDoH items, indicating possible patient reticence to respond to some questions. Symptom reporting differences may indicate a potential need to focus on patients living alone or without a caregiver. Results support the importance and utility of SDoH indicators to identify actionable risk factors for poor health outcomes. Further exploration is needed to understand reporting of symptoms and caregiver/lifestyle arrangements.

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Quality, Safety, and Implementation Science,Cost, Value, and Policy,Patient Experience,Survivorship

Sub Track

Integrating Patient Experience Assessment and Patient Reported Outcomes Into Practice

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 353)

DOI

10.1200/OP.2023.19.11_suppl.353

Abstract #

353

Poster Bd #

F10

Abstract Disclosures

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