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Baxter K, Agnew H, Morgan J, Holland C, Flynn D, Edmondson R. Patient and clinician priorities for information on treatment outcomes for advanced ovarian cancer: a Delphi exercise. J Gynecol Oncol 2024; 35:35.e63. [PMID: 38576342 DOI: 10.3802/jgo.2024.35.e63] [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: 10/19/2023] [Revised: 01/03/2024] [Accepted: 02/11/2024] [Indexed: 04/06/2024] Open
Abstract
OBJECTIVE Patients with advanced ovarian cancer face a range of treatment options, and there is unwarranted variation in treatment decision-making between UK providers. Decision support tools that produce data on treatment outcomes as a function of individual patient characteristics, would help both patients and clinicians to make informed, preference- and values-based choices. However, data on treatment outcomes to include in such tools are lacking. METHODS Following a literature review, a questionnaire was designed for use in a Delphi process to establish which treatment outcomes are important to both patients and clinicians in decision-making for treatment for advanced ovarian cancer. Patient and clinician panels were established. RESULTS Following 2 Delphi rounds, consensus was achieved for 7/11 items in the patient panel and 8/11 items in the clinician panel. Consensus across both panels was achieved for inclusion of both overall survival and progression free survival as important items in the decision-making process, although there remained differences of opinion as to whether these should be presented as relative or absolute values. CONCLUSION Information needs for treatment decision-making in ovarian cancer differ between and within patient and clinician groups. Whilst overall survival and progression free survival are universally accepted as important data items, decision support tools will need to be nuanced to allow presentation of a range of outcomes and associated probabilities, and in a range of formats, that can be tailored to the preferences of clinician and patients.
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Affiliation(s)
- Kathryn Baxter
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Heather Agnew
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Jennie Morgan
- Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Cathrine Holland
- Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Darren Flynn
- Department of Nursing, Midwifery and Health, University of Northumbria, Newcastle upon Tyne, United Kingdom
| | - Richard Edmondson
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- Department of Gynaecological Oncology, Manchester University NHS Foundation Trust, Manchester, United Kingdom.
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Geisler J, Karihtala P, Tuxen M, Valachis A, Holm B. Current treatment landscape of HR+/HER2- advanced breast cancer in the Nordics: a modified Delphi study. Acta Oncol 2023; 62:1680-1688. [PMID: 37713138 DOI: 10.1080/0284186x.2023.2254475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 08/06/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND This Delphi study aimed to assess current perspectives on hormone receptor-positive/human epidermal growth factor receptor 2-negative(HR+/HER2-) advanced breast cancer (aBC) treatment strategies across the Nordics, and to establish where consensus exists across the Nordics on HR+/HER2- aBC treatment. MATERIAL AND METHODS A modified, three-round Delphi method was followed. A steering committee was appointed for study coordination, panellist selection, and questionnaire development. The questionnaires covered relevant topics on HR+/HER2- aBC treatment: treatment patterns in different lines of therapy (first [1L], second [2L], and third [3L]), oligometastatic disease, de novo aBC, brain metastases, age as influential factor, visceral crisis, radiotherapy, diagnostics, and clinical guidelines. Both open and closed-ended questions were included. Consensus was defined as at least 70% agreement. RESULTS In total, 28 experienced BC oncologists participated in the study from all five Nordic countries. Overall, topics reaching consensus included: preferred treatment approach in 1L and 2L therapy, treatment of oligometastatic disease, visceral crisis, brain metastases, and age-related treatment considerations. No consensus was reached for 3L therapy and local treatment for primary tumour in de novo aBC. Endocrine therapy (ET) combined with a cyclin-dependent kinase (CDK)4/6 inhibitor was the treatment of choice for 1L and 2L therapy. Treatment patterns in clinical practice did not always follow recommendations in current Nordic guidelines, as seen in the case of recently approved treatments. DISCUSSION ET in combination with a CDK4/6 inhibitor is the preferred frontline treatment for HR+/HER2- aBC in the Nordics. The observed discrepancy between current guidelines and clinical practice could be due to differences in the reimbursement of novel treatments in the Nordics. Collaborative research efforts are warranted for topics that lack consensus.
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Affiliation(s)
- Jürgen Geisler
- Department of Oncology, University of Oslo and Akershus University Hospital, Akershus, Norway
| | - Peeter Karihtala
- Department of Oncology, Helsinki University Hospital Comprehensive Cancer Centre and University of Helsinki, Helsinki, Finland
| | - Malgorzata Tuxen
- Department of Oncology, University of Copenhagen Herlev Hospital, Copenhagen, Denmark
| | - Antonis Valachis
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Barbro Holm
- Department of Oncology, Novartis, Stockholm, Sweden
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'It made me feel part of the team, having my homework to do' - women and specialist nurse experiences of remote follow-up after ovarian cancer treatment: a qualitative interview study. Support Care Cancer 2023; 31:2. [PMID: 36512093 PMCID: PMC9745768 DOI: 10.1007/s00520-022-07470-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE Ovarian cancer patients require monitoring for relapse post-treatment, and alternative follow-up pathways are increasing, which require in-depth exploration to ensure acceptability and inform implementation. This study aimed to explore women and specialist nurses' experiences of participating in a feasibility study of an electronic patient-reported outcome (ePRO) follow-up pathway after ovarian cancer treatment. METHODS The feasibility study incorporated an ePRO questionnaire, blood test and telephone consultation with a specialist nurse, instead of face-to-face hospital visits. All women and the nurses involved were invited to take part in nested semi-structured interviews. Interviews were recorded and transcripts analysed using framework analysis. RESULTS Twenty interviews were conducted (16 out of 24 women who took part in the feasibility study and all 4 nurses). Four themes were identified: (1) readiness and motivators, (2) practicalities and logistics, (3) personal impact and (4) future role. An overarching theme highlighted how women strived to seek reassurance and gain confidence. Most women and nurses were positive about the ePRO pathway and would happily continue using it. CONCLUSION This work provides invaluable insight into the experiences of women on remote ePRO follow-up post-treatment. Important logistic and implementation issues were identified, which should inform future large-scale work to introduce and evaluate remote ePRO methods in cancer follow-up. This work highlights the key factors influencing women's readiness and acceptability of an ePRO pathway, and how services should be carefully designed to ensure patients feel reassured and confident post-treatment. Furthermore, it highlights that flexibility and patient preference should be considered in remote service delivery. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT02847715 (first registered 19 May 2016).
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Yuo TH, Kim CY, Rajan DK, Niyyar VD, Murea M, Dillavou ED, Bream PR, Dinwiddie LC, Hohmann SE, Woo K, Vachharajani T, Roberts C, Gooden C, Wright GW, Hogan AJ, Ferko NC, Kahle E, Clynes D, Lok CE. Hemodialysis Arteriovenous Access Cosmesis Scale (AVACS): A new measure for vascular access. J Vasc Access 2022:11297298221141499. [PMID: 36517942 DOI: 10.1177/11297298221141499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RATIONALE AND OBJECTIVE This study aimed to develop a cosmesis scale to evaluate the cosmetic appearance of hemodialysis (HD) arteriovenous (AV) accesses from the perspective of the patient and clinician, which could be incorporated into clinical trials. STUDY DESIGN Using a modified Delphi process, two AV access cosmesis scale (AVACS) components were developed in a four-round Delphi panel consisting of two surveys and two consensus meetings with two rounds of patient consultation. SETTING AND PARTICIPANTS The Delphi panel consisted of 15 voting members including five interventional or general nephrologists, five vascular surgeons, three interventional radiologists, and two vascular access nurse coordinators. Four patients experienced with vascular access were involved in patient question development. ANALYTICAL APPROACH For a component to be included in the AVACS, it had to meet the prespecified panel consensus agreement of ⩾70%. RESULTS The clinician component of the AVACS includes nine questions on the following AV access features: scarring, skin discoloration, aneurysm/pseudoaneurysms and megafistula appearance. The patient component includes six questions about future vascular access decisions, interference with work or leisure activities, clothing choices, self-consciousness or attractiveness, emotional impact, and overall appearance. LIMITATIONS Delphi panel methods are subjective by design, but with expert clinical opinion are used to develop classification systems and outcome measures. The developed scale requires further validation testing but is available for clinical trial use. CONCLUSIONS While safety and efficacy are the primary concerns when evaluating AV access for HD, cosmesis is an important component of the ESKD patient experience. The AVACS has been designed to assess this important domain; it can be used to facilitate patient care and education about vascular access choice and maintenance. AVACS can also be used to inform future research on developing new techniques for AV access creation and maintenance, particularly as relates to AV access cosmesis.
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Affiliation(s)
- Theodore H Yuo
- Division of Vascular Surgery, Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Charles Y Kim
- Division of Interventional Radiology, Duke University Medical Center, Durham, NC, USA
| | - Dheeraj K Rajan
- Division of Vascular & Interventional Radiology, Department of Medical Imaging, University of Toronto, University Health Network, Toronto, ON, Canada
| | - Vandana D Niyyar
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Marianna Murea
- Section on Nephrology, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Peter R Bream
- Vascular and Interventional Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Karen Woo
- Division of Vascular Surgery, Department of Surgery, David Geffen School of Medicine at UCLA, University of California Los Angeles, Los Angeles, CA, USA
| | - Tushar Vachharajani
- Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
| | - Cynthia Roberts
- Renal Research Institute, University of North Carolina at Chapel Hill Nephrology and Hypertension Division, Chapel Hill, NC, USA
| | - Christie Gooden
- North Texas Dialysis Access Clinic, Medical City Dallas, TX, USA
| | | | | | | | - Erin Kahle
- American Association of Kidney Patients, Tampa, FL, USA
| | - Diana Clynes
- American Association of Kidney Patients, Tampa, FL, USA
| | - Charmaine E Lok
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Nephrology, Department of Medicine, University Health Network-Toronto General Hospital, Toronto, ON, Canada
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Audag N, Cnockaert P, Reychler G, Poncin W. Consensus on Nasal Irrigation in Infants: A Delphi Study. Ann Otol Rhinol Laryngol 2022; 132:674-683. [PMID: 35833594 DOI: 10.1177/00034894221112514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Nasal irrigation is regularly used in infants to relieve upper airway symptoms. However, because there is no consensus on good practice, nasal irrigation in infants is described and applied heterogeneously among clinicians and between clinical trials. OBJECTIVE The aim of this study was to establish consensus regarding the use of nasal irrigation in infants. METHODS A panel of Belgian physiotherapists and physicians experienced in performing nasal irrigation in infants were surveyed using the Delphi technique. Three survey rounds were used. Participants rated their level of (dis)agreement to each statement in each round using a 6-point Likert scale. Consensus was defined for statements which collected at least 75% of responses in agreement or disagreement. The questionnaire of Round 1 was built on nasal irrigation practice habits previously collected from parents, childcare workers, and healthcare professionals. Questionnaires from rounds 2 and 3 were amended based on experts written feedback. RESULTS Thirty experts (12 physicians and 18 physiotherapists) completed all 3 questionnaires. Consensus was achieved for 47 of 75 statements (63%) distributed over the following domains: "contraindications," "indications and frequency of use," "irrigation means," "solution preparation," "solution volume," "realization of the technique," and "assessment of the efficacy of nasal irrigation." CONCLUSION This study provides the first well-constructed consensus on good practice on nasal irrigation in infants. Consensus on several statements across different domains were established but require validation in future trials. This study also proposes direction for future research focusing on statements that did not reach consensus.
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Affiliation(s)
- Nicolas Audag
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute Ecole Vinci-Secteur Santé-Département de kinésithérapie, Brussels, Belgium
| | - Pierre Cnockaert
- Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute Ecole Vinci-Secteur Santé-Département de kinésithérapie, Brussels, Belgium
| | - Gregory Reychler
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute Ecole Vinci-Secteur Santé-Département de kinésithérapie, Brussels, Belgium
| | - William Poncin
- Institut de recherche expérimentale et clinique (IREC), pôle de Pneumologie, ORL et Dermatologie, Université Catholique de Louvain, Brussels, Belgium.,Secteur de kinésithérapie et ergothérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Service de pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.,Haute Ecole Vinci-Secteur Santé-Département de kinésithérapie, Brussels, Belgium
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Kennedy F, Shearsmith L, Holmes M, Rogers Z, Carter R, Hofmann U, Velikova G. Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study. BMC Cancer 2022; 22:726. [PMID: 35780095 PMCID: PMC9250717 DOI: 10.1186/s12885-022-09817-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
Background Ovarian cancer patients require monitoring for relapse. Innovative follow-up methods are increasingly being explored. An electronic patient-reported outcome (ePRO) follow-up pathway was developed for women treated for ovarian cancer. This feasibility study explored patient acceptability and compliance. Methods A single-arm non-blinded prospective feasibility study was undertaken at two hospitals. Participants were women who had completed treatment for ovarian cancer whose clinician was happy for them to be monitored remotely. Automated 3-monthly reminders were sent to participants to complete an ePRO questionnaire and obtain blood tests. Participants were reviewed over the phone by their clinical nurse specialist instead of attending clinic-based follow-up. The primary outcome was compliance (expected ePRO completions/blood tests) across the 12-month study period. Secondary outcomes were recruitment, attrition, resource use, symptom severity/alerts and patient acceptability. Results Twenty-four women consented (50% consent rate), and 13 remained on study at 12 months. Seven women relapsed, 3 chose to withdraw, and 1 withdrew for other clinical reasons. ePRO compliance was high and consistent at 75-82%, although the two hospitals differed. Adherence to the clinical protocol was evident for blood tests and contacts with staff (fewer visits, more phonecalls compared to an earlier audit). End-of-study feedback indicated high patient satisfaction. Conclusions Remote ePRO follow-up for ovarian cancer is feasible and acceptable to patients who are able and willing to participate. However, the low recruitment rate (ineligible + declined) indicate it is not suitable/acceptable to all patients immediately post-treatment. Further large-scale research and implementation work is required, especially in a post-COVID era. Trial registration ClinicalTrials.gov ID: NCT02847715 (first registered 19/05/2016). Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-09817-5.
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Affiliation(s)
- Fiona Kennedy
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK.
| | - Leanne Shearsmith
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - Marie Holmes
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - Zoe Rogers
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - Rob Carter
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
| | - Uschi Hofmann
- Calderdale & Huddersfield NHS Foundation Trust, Huddersfield Royal Infirmary, Acre St, Lindley, Huddersfield, HD3 3EA, UK
| | - Galina Velikova
- Section of Patient Centred Outcomes Research, Patient Reported Outcomes Group, Leeds Institute of Medical Research at St James's, University of Leeds, Bexley Wing, Beckett Street, Leeds, LS9 7TF, UK
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Escudero-Vilaplana V, Bernal E, Casado G, Collado-Borrell R, Diez-Fernández R, Fernández Román AB, Folguera C, González-Cortijo L, Herrero-Fernández M, Marquina G, Martínez Nieto C, Rodríguez MA, Rubio AR, Sanmartin-Fenollera P, Vazquez Castillo MJ, Comellas M, Guerra EM. Defining a Standard Set of Patient-Reported Outcomes for Patients With Advanced Ovarian Cancer. Front Oncol 2022; 12:885910. [PMID: 35664764 PMCID: PMC9159390 DOI: 10.3389/fonc.2022.885910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Advanced ovarian cancer (AOC) and its treatment cause several symptoms and impact on patients’ health-related quality of life (HRQoL). We aim to reach a consensus on the most relevant patient-reported outcome (PROs), the corresponding measures (PROMs), and measurement frequency during AOC patients’ follow-up from patients’ and healthcare professionals’ (HCP) perspective. Methods The project comprised five steps: 1) a literature review, 2) a focus group with patients, 3) a nominal group with HCP, 4) two round-Delphi consultations with patients and HCP, and 5) a final meeting with HCP. Delphi questionnaire was elaborated based on literature review, focus group (n=5 patients), and nominal group (n=16 HCP). The relevance of each PRO and the appropriateness (A) and feasibility (F) of the proposed PROM were assessed (Likert scale 1=strongly agree; 9=strongly disagree). The consensus was reached when at least 75% of the panelists rated it as ‘relevant’, ‘appropriate’, or ‘feasible’ (score 7-9). Results A total of 56 HCP [51.8% Hospital Pharmacy; 41.1% Oncology; 3.6% Nursing; and 3.6% Psycho-oncology; mean time in specialty 12.5 (8.0) years] and 10 AOC patients [mean time diagnosis 5.4 (3.0) years] participated in the 1st round. All PROs achieved consensus regarding their relevance, except dry skin (58.0%). Agreement was reached for PRO-CTCAE to be used to assess fatigue (A:84.9%; F:75.8%), neuropathy (A:92.4%; F:77.3%), diarrhea (A:87.9%; F:88.7%), constipation (A:86.4%; F:75.8%), nausea (A:89.4%; F:75.8%), insomnia (A:81.8%; F:88.7%), abdominal bloating (A:82.2%; F:82.2%) and sexuality (A:78.8%; F:88.6%); EQ-5D to determine patients’ HRQoL (A:87.9%; F:80.3%), pain (A:87.9%; F:75.8%) and mood (A:77.7%; F:85.5%); to assess treatment adherence the Morisky-Green (A:90.9%; F:84.9%) and the dispensing register (A:80.3%; F:80.3%) were chosen. It was agreed to note in the medical record whether the patient’s treatment preferences had been considered during decision-making (A:78.8%; F:78.8%) and to use a 5-point Likert scale to assess treatment satisfaction (A:86.4%; F:86.4%). Panelists agreed (A:92.4%; F: 77.3%) to collect these PROs (1) at the time of diagnosis/relapse; (2) one month after starting treatment/change therapeutic strategy; (3) every three months during the 1st-year of treatment; and later (4) every six months until treatment completion/change. Conclusions The consensus reached represents the first step towards including the patient’s perspective in AOC follow-up. The standardized collection of PROs in clinical practice may contribute to optimizing the follow-up of these patients and thus improving the quality of care.
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Affiliation(s)
| | - Elsa Bernal
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Gema Casado
- Hospital Pharmacy, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Carlos Folguera
- Hospital Pharmacy, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain
| | - Lucía González-Cortijo
- Breast and Gynecological Tumor Unit, Hospital Universitario Quirónsalud Madrid, Madrid, Spain
| | | | - Gloria Marquina
- Department of Medical Oncology, Hospital Clinico san Carlos, Madrid, Spain.,Department of Medicine, School of Medicine, Universidad Complutense de Madrid (UCM), Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | | | | | - Ana Rosa Rubio
- Hospital Pharmacy, Hospital Universitario de Toledo, Toledo, Spain
| | | | | | | | - Eva Maria Guerra
- Department of Medical Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain
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Kennedy F, Shearsmith L, Holmes M, Peacock R, Lindner OC, Megson M, Velikova G. 'We do need to keep some human touch'-Patient and clinician experiences of ovarian cancer follow-up and the potential for an electronic patient-reported outcome pathway: A qualitative interview study. Eur J Cancer Care (Engl) 2022; 31:e13557. [PMID: 35146821 PMCID: PMC9287040 DOI: 10.1111/ecc.13557] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 09/30/2021] [Accepted: 01/26/2022] [Indexed: 12/29/2022]
Abstract
Objective This study aimed to explore experiences of follow‐up after treatment and views on an electronic patient‐reported outcome (ePRO) pathway among ovarian cancer patients and clinicians. Methods Semi‐structured qualitative interviews were conducted with clinicians and patients previously treated for ovarian cancer. Interviews explored experiences of the current follow‐up pathway, patients' needs and views on an ePRO pathway enabling patients to report symptoms online rather than attend clinic‐based appointments. Transcripts were analysed using framework analysis. Results Sixteen patients and 10 clinicians participated from four hospitals in England. Four key themes were identified: transition into follow‐up, key features of effective follow‐up, issues in follow‐up and views of ePRO. Both patients and clinicians saw benefits of an ePRO pathway alongside continued access to specialist support and discussed various practicalities (e.g., frequency, introduction and communication). Technology concerns and feelings of abandonment were highlighted as barriers. The proposed impact on clinical and individual patient outcomes was discussed. Conclusion Patient and clinician views on follow‐up and an ePRO pathway informed key recommendations on the development/introduction of ePRO follow‐up. Technology use in healthcare will continue to grow and may offer solutions to facilitate responsive and tailored care. Further research should explore the safety, experiences and acceptability of ePRO follow‐up.
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Affiliation(s)
- Fiona Kennedy
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK
| | - Leanne Shearsmith
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK.,Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Marie Holmes
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK
| | - Rosemary Peacock
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK
| | - Oana C Lindner
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK
| | - Molly Megson
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK.,Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Galina Velikova
- Section of Patient-Centred Outcomes Research, Leeds Institute of Medical Research (LIMR) at St James's, University of Leeds, Leeds, UK
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