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Engstrom T, Tanner S, Lee WR, Forbes C, Walker R, Bradford N, Pole JD. Patient reported outcome measure domains and tools used among adolescents and young adults with cancer: A scoping review. Crit Rev Oncol Hematol 2023; 181:103867. [PMID: 36427770 DOI: 10.1016/j.critrevonc.2022.103867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/23/2022] Open
Abstract
Adolescent and young adult (AYA) cancer patients and survivors are growing and face with distinct issues from paediatric and older cancer survivors. Hence it is important the issues they encounter are measured using appropriate Patient Reported Outcome Measures (PROMs). We searched PubMed, EMBASE, CINAHL, and PsycINFO for articles including: (1) AYAs (ages 15-39), (2) Malignant neoplasms, and (3) PROMs. This resulted in 3566 unique articles, 523 were included for full text review, of which 175 were included. These studies included 203 distinct tools to measure PROMs across 31 domains. Physical function was most frequently measured domain, followed by social, emotional and mental health. The most commonly used tools were the EORTC QLQ-C30, HADS and SF-36. PROMs used in AYA cancer patients is a complex topic, this comprehensive review serves as a useful reference for researchers, clinicians and health services who want to better understand, and improve, outcomes among their patients.
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Affiliation(s)
- Teyl Engstrom
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Sarah Tanner
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Wen Ray Lee
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Cheryl Forbes
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia
| | - Rick Walker
- School of Medicine, The University of Queensland, Herston, QLD, Australia; Queensland Children's Hospital, Brisbane, QLD, Australia; Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Natalie Bradford
- Cancer and Palliative Care Outcomes Centre at Centre for Children's Health Research, Queensland University of Technology, Australia
| | - Jason D Pole
- Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada.
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Bradford N, Slater P, Fielden P, Condon P, Skrabal Ross X, Douglas M, Radford C, Carter A, Walker R, Badat A, Edwards R, Spencer B, Herbert A. Care at Your Fingertips: Codesign, Development, and Evaluation of the Oncology Hub App for Remote Symptom Management in Pediatric Oncology. JCO Clin Cancer Inform 2023; 7:e2200134. [PMID: 36706346 DOI: 10.1200/cci.22.00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To codesign, develop, and evaluate a smartphone app that includes patient-reported measures of symptoms and real-time advice in children's cancer. METHODS The Oncology Hub is a comprehensive approach to symptom management that includes a suite of codesigned tools and resources including clinical algorithms to determine the level of concern, symptom management advice, and resources for families of children with cancer. The evaluation involved Think Aloud interviews with parent and adolescent patients to complete tasks in the app as well as a User Experience questionnaire (score range, 0-120) and qualitative feedback. The accuracy of algorithms was determined by repeated testing of inputs and outputs over 4 weeks. RESULTS Design and wireframes were iteratively refined through consultation with parents and adolescents confirming the final design. Beta testing evaluation was then completed by 25 participants including two adolescents. Across all participants, 84% of tasks were easy to navigate, and the Oncology Hub demonstrated high usability, usefulness, and acceptability with participants' scores ranging between 90 and 120 (mean = 112.2, standard deviation = 9.43). Qualitative feedback was positive. Testing of algorithms identified inconsistencies in understanding between clinical research and coding teams; refinements were made until the expected response notifications were returned with 100% accuracy. CONCLUSION Technology offers new ways to think about how clinicians and families communicate and share information to harness the best of community and hospital services. Understanding how information is exchanged using health apps, and how this affects clinical workflow is critical to successful implementation, and optimizing symptom assessment and management in children with cancer.
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Affiliation(s)
- Natalie Bradford
- Queensland University of Technology, Brisbane, Australia.,Children's Health Queensland, South Brisbane, Australia
| | | | | | - Paula Condon
- Children's Health Queensland, South Brisbane, Australia
| | | | | | | | - Amanda Carter
- Children's Health Queensland, South Brisbane, Australia
| | - Rick Walker
- Children's Health Queensland, South Brisbane, Australia
| | - Ashraf Badat
- Children's Health Queensland, South Brisbane, Australia
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Bradford N, Condon P, Pitt E, Tyack Z, Alexander K. Optimising symptom management in children with cancer using a novel mobile phone application: protocol for a controlled hybrid effectiveness implementation trial (RESPONSE). BMC Health Serv Res 2021; 21:942. [PMID: 34503489 PMCID: PMC8427146 DOI: 10.1186/s12913-021-06943-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 08/26/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Intense and aggressive treatment regimens for most children's cancer have achieved vast improvements in survival but are also responsible for both a high number and burden of symptoms. The use of Patient Reported Outcome Measures (PROMs) demonstrates a range of benefits for improved symptom management in adults with cancer. There are, however, multiple barriers to integrating PROMs into routine care in children and adolescents with cancer. This study aims to evaluate: (1) the effectiveness of electronic PROMs to generate stratified alerts, symptom management recommendations and graphical summaries (the RESPONSE system) to improve health outcomes and (2) the implementation of the RESPONSE system by assessing feasibility, acceptability, satisfaction, and sustainability. METHODS A pragmatic hybrid II effectiveness-implementation controlled trial, using mixed methods, will be undertaken, advancing both knowledge of the effectiveness of the intervention and implementation factors. One-hundred and sixty children with cancer receiving active treatment will be recruited 1:1 to a non-randomised study involving two groups with an equal number of participants in each group. The intervention group (n = 80) will be prospectively recruited to receive the RESPONSE system intervention over eight weeks, versus the historical matched control group (n = 80) who will complete the ePROMs without access to the RESPONSE system. The primary outcome of the effectiveness trial is change between groups in total symptom burden. Secondary outcomes include child health-related quality-of-life and implementation outcomes. Trial data will be analysed using linear mixed-effects models. Formative implementation evaluation is informed by CFIR and ERIC frameworks and implementation outcomes will be mapped to the RE-AIM framework and include interviews, field notes, as well as administrative data to evaluate feasibility, acceptability, satisfaction and sustainability. TRIAL REGISTRATION NUMBER ACTRN12621001084875 . Retrospectively Registered 16 August 2021.
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Affiliation(s)
- Natalie Bradford
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia.
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, 62 Graham St, South Brisbane, QLD, 4101, Brisbane, Australia.
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia.
| | - Paula Condon
- Centre for Children's Health Research, Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, 62 Graham St, South Brisbane, QLD, 4101, Brisbane, Australia
| | - Erin Pitt
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia
| | - Zephanie Tyack
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia
| | - Kimberly Alexander
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Brisbane, Australia
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