Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients
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...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Becaris Publishing Limited
2023-08-01
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| Series: | Journal of Comparative Effectiveness Research |
| Subjects: |
| _version_ | 1797660353222410240 |
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| author | Jessie T Yan Devon J Boyne Ernest Lo Eliya Farah Dylan E O’Sullivan Winson Y Cheung |
| author_facet | Jessie T Yan Devon J Boyne Ernest Lo Eliya Farah Dylan E O’Sullivan Winson Y Cheung |
| author_sort | Jessie T Yan |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-11T18:29:38Z |
| format | Article |
| id | doaj.art-0eb0ab4a266643498f088ade8730d60f |
| institution | Directory Open Access Journal |
| issn | 2042-6313 |
| language | English |
| last_indexed | 2024-03-11T18:29:38Z |
| publishDate | 2023-08-01 |
| publisher | Becaris Publishing Limited |
| record_format | Article |
| series | Journal of Comparative Effectiveness Research |
| spelling | doaj.art-0eb0ab4a266643498f088ade8730d60f2023-10-13T13:16:15ZengBecaris Publishing LimitedJournal of Comparative Effectiveness Research2042-63132023-08-01121010.57264/cer-2023-0061Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patientsJessie T Yan0https://orcid.org/0000-0003-1047-8158Devon J Boyne1Ernest Lo2Eliya Farah3Dylan E O’Sullivan4Winson Y Cheung5Roche Information Solutions, Roche Diagnostics, Santa Clara, CA 95050, USADepartment of Oncology, University of Calgary, Calgary, Alberta, T2N 4N2, CanadaRoche Information Solutions, Roche Diagnostics, Santa Clara, CA 95050, USADepartment of Oncology, University of Calgary, Calgary, Alberta, T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, T2N 4N2, CanadaDepartment of Oncology, University of Calgary, Calgary, Alberta, T2N 4N2, CanadaAim: 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.canceroverall survivalpatient-reported outcomesquality of lifereal-world impact symptoms |
| spellingShingle | Jessie T Yan Devon J Boyne Ernest Lo Eliya Farah Dylan E O’Sullivan Winson Y Cheung Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients Journal of Comparative Effectiveness Research cancer overall survival patient-reported outcomes quality of life real-world impact symptoms |
| title | Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients |
| title_full | Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients |
| title_fullStr | Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients |
| title_full_unstemmed | Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients |
| title_short | Real-world impact of patient-reported outcome measurement on overall survival, healthcare use and treatment discontinuation in cancer patients |
| title_sort | real world impact of patient reported outcome measurement on overall survival healthcare use and treatment discontinuation in cancer patients |
| topic | cancer overall survival patient-reported outcomes quality of life real-world impact symptoms |
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