Patient-Reported Outcomes Bolster Breast Cancer Treatment

Patients, providers, and healthcare processes benefit from systematically collecting patient-reported outcomes and reviews of their experiences in breast cancer treatment, according to a new study by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

The findings show that patient-reported outcome measures (PROMs) could be of most benefit if standardized across healthcare, despite the difficulties in getting that level of cross-sectional partnership, write the authors from Holland, in the latest issue of the indexed ISPOR journal Value in Health. 

“Although 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,” wrote the authors. 

The survey of the various patient information collection systems was pulled from the literature. The team from Rasmus MC Cancer institute, the Erasmus University Medical Center, and the Amsterdam Public Health Research Institute scoured databases such as Embase, MEDLINE, PsycINFO, Cochrane Central, CINAHL, and Web of Science. 

A total of 2311 articles were scoured. But the vast majority of them were excluded, with more than 2100 ruled out because they did not include breast cancer patients, or “had an irrelevant aim by focusing on PROMs as an evaluation method, endpoint, or outcome,” among other reasons. The final tally for evaluation was 34 studies-16 of which included exclusively patients with breast cancer, and 18 or which had patients with breast tumors as a subset of their overall groups. (A total sum of patients across all the published material was 14,083-of which 11,191 were patients with breast cancer). 

Seventeen PROMs were collected electronically, and 7 of those relied on Web-based assessments, with 6 more collected on tablet, 2 more by an e-Health application, and 1 each by email and by a software system. Four additional studies used electronic combined with paper-based methods to get the data. Nine studies used telephone interventions. One used only paper. 

The majority of the studies showed that PROM improved a variety of factors among patients, providers, and the care process or healthcare system. 

For patients, some symptom prevalence and distress was reduced in the PROM-reached population, according to the paper. For providers, the PROMs helped identify areas of concern, and bolster both compliance and clinical decision making, the study found. 

For the care process outcomes, patient-provider communication was improved, the authors concluded.

A number of PROMs have already been validated within the breast cancer population: the BREAST-Q, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Cancer Patients, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Breast, and the Function Assessment of Cancer Therapy-Endocrine Subscale, among others. 

Expanding those options, and making them more widely comparable, will benefit everyone, the study concluded. 

“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,” the authors concluded. 

References:

van Eggdom L, Oemrawsingh A, Verweij L, et al. Implementing Patient-Reported Outcome Measures in Clinical Breast Cancer Care: A SystematicReview. Value Health. 2019 Oct;22(10):1197-1226. doi: 10.1016/j.jval.2019.04.1927.