J Clin Oncol: Cancer patients who actively self-monitor have a relatively better prognosis!

Monitoring of symptoms and needs using patient-reported outcomes (PROs) is associated
with improved clinical outcomes for cancer treatment.
These improvements were mainly seen in non-Hispanic white patients, with higher
completion rates of assessment using English.
However, the documented impact of such monitoring on system-level outcomes, including emergency department (ER) visits and hospitalizations, remains unclear
.

The study explored the factors influencing PRO surveillance while assessing clinical prognosis
in an outpatient oncology setting with diverse racial, ethnic, and linguistic populations.

The researchers conducted a retrospective analysis (October 2019-February 2022) of cancer patients participating in the My Wellness Check (MWC) trial, with patient portal management and electronic health record-based PRO assessment automatically alerting
oncology providers.
Patient demographics, clinical features, and clinical outcomes
were also collected.
The Logistic regression model was used to test the factors
affecting MWC questionnaire completion.
Demographic adjustments were made using the Cox proportional hazards regression model to assess the cumulative incidence
of emergency department visits and hospitalizations.

Overall quality of life

A total of 9553 patients were included, of which 43.
1% (n=4117) returned to one or more questions
.
Aged 65 years and older (adjusted odds ratio [aOR] = 0.
77, p<0.
0001), male (aOR=0.
81, p<0.
0001), Hispanic or Latino (aOR=0.
70, p<0.
0001), unmarried (aOR=0.
75, p<0.
0001), or untreated (aOR=0.
76, p<).
0.
0001) patients were less likely to respond to the MWC questionnaire
.
Patients who completed the overall MWC questionnaire had a much
lower risk of emergency department visits (adjusted hazard ratio = 0.
78, p<0.
0001) and hospitalization (adjusted hazard ratio = 0.
80, p=0.
0007) than those who did not complete the questionnaire.

In summary, completion of an electronic health record-based PRO assessment was associated
with significantly better clinical outcomes in different cancer patient populations.
Questionnaires for specific patient groups were assessed as less motivated
.
Further research is needed to identify barriers to the completion of PRO measures and the long-term benefits of
such projects.

Original source:

Akina Natori, et al.
Symptoms and Needs Monitoring in Diverse Ambulatory Oncology Patients: Usage Characteristics and Impact on Emergency Room Visits and Hospitalization.
Journal of Clinical Oncology.
J Clin Oncol.
October 10, 2022.
https://ascopubs.
org/doi/full/10.
1200/JCO.
22.
01038