| Summary: | Aim: The purpose of this retrospective, population-based, observational cohort analysis was to assess
whether routine patient-reported outcomes (PRO) monitoring alone has an impact on real-world overall
survival (OS) and hospitalizations among individuals diagnosed with lung, breast or colorectal cancer.
The importance of follow-up care in post-PRO data collection was also discussed. Patients & methods:
Administrative databases covering 17 cancer centers from Alberta, Canada were queried and individuals
≥18 years old and diagnosed with lung, breast or colorectal cancer from 1 January 2016 to 31
December 2019 were included and followed until 31 December 2020. Patients were stratified by whether
they received routine PRO monitoring initiated within 120 days of diagnosis and matched 1:1 with use of
propensity scores based on baseline characteristics. OS was assessed from the index date to death, and the
respective Kaplan–Meier curves were estimated along with hazard ratios from Cox Proportional Hazard
Models. Linear and logistic regression models were used to estimate mean differences and odds ratios
(OR) respectively for healthcare resource utilization events including cancer physician visits, emergency
department visits and outpatient ambulatory care encounters. Results: 4800 patients were included in
each matched cohort. There was no statistically significant difference between PRO monitoring and
non-monitoring cohorts in OS (HR = 1.01; 95% CI: 0.93–1.09; p = 0.836) and treatment discontinuation
(OR = 0.98; 95% CI: 0.85–1.12; p = 0.75). Median OS was 51.5 months for unmonitored cohort (95% CI:
47.5–NA) versus 50.6 months for monitored cohort (95% CI: 47.6–55.7). Compared with PRO-monitored
patients, unmonitored patients were associated with lower hospitalization risks (OR = 1.12; 95% CI:
1.03–1.22; p = 0.01). However, PRO-monitored patients experienced significantly fewer physician visits
in comparison to unmonitored patients (MD = -1.036; 95% CI: -1.288 to -0.784, p < 0.001). Conclusion:
Our results show that capturing patient-reported symptoms alone reduced the number of physician visits
but neither reduced hospitalizations nor improved OS in this real-world cancer population. To drive more
meaningful clinical impact, PRO monitoring programs must be met with rigorous follow-up response to
the identified symptoms.
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