Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A Systematic Review

• Published in: Value in health 2019-10, Vol.22 (10), p.1197-1226
• Main Authors: van Egdom, Laurentine S.E., MD, Oemrawsingh, Arvind, MD, MHS, Verweij, Lisanne M., PhD, Lingsma, Hester F., PhD, Koppert, Linetta B., MD, PhD, MSc, Verhoef, Cornelis, MD, PhD, Klazinga, Niek S., MD, PhD, Hazelzet, Jan A., MD, PhD
• Format: Article
• Language: English
• Subjects: Breast cancer; breast cancer care; Clinical decision making; Clinical medicine; Clinical outcomes; Collection; Decision making; Generalizability; implementation; Internal Medicine; Intervention; Medical referrals; Medical screening; Patient communication; patient-reported outcome measures; Patients; Psychological distress; Quality of life; Standardization; Symptom management; Systematic review; value
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2019.04.1927

AbstractBackgroundPatient-reported outcome measures (PROMs) are increasingly being used to improve care delivery and are becoming part of routine clinical practice. ObjectiveThis systematic review aims to give an overview of PROM administration methods and their facilitators and barriers in breast cancer clinical practice. MethodsA systematic literature search was conducted in Embase, MEDLINE, PsycINFO, Cochrane Central, CINAHL, and Web of Science for potentially relevant articles from study inception to November 2017. Reference lists of screened reviews were also checked. After inclusion of relevant articles, data were extracted and appraised by 2 investigators. ResultsA total of 2311 articles were screened, of which 34 eligible articles were ultimately included. Method and frequency of PROM collection varied between studies. The majority of studies described a promising effect of PROM collection on patients (adherence, symptom distress, quality of life, acceptability, and satisfaction), providers (willingness to comply, clinical decision making, symptom management), and care process or system outcomes (referrals, patient-provider communication, hospital visits). A limited number of facilitators and barriers were identified, primarily of a technical and behavioral nature. ConclusionAlthough interpreting the impact of PROM collection in breast cancer care is challenging owing to considerations of synergistic (multicomponent) interventions and generalizability issues, this review found that systematic PROM collection has a promising impact on patients, providers, and care processes/ systems. Further standardization and reporting on method and frequency of PROM collection might help increase the effectiveness of PROM interventions and is warranted to enhance their overall impact.