Assessing Patient-Reported Outcomes in Routine Cancer Clinical Care Using Electronic Administration and Telehealth Technologies : Realist Synthesis of Potential Mechanisms for Improving Health Outcomes
©Ramkumar Govindaraj, Meera Agar, David Currow, Tim Luckett. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.11.2023..
BACKGROUND: The routine measurement of patient-reported outcomes in cancer clinical care using electronic patient-reported outcome measures (ePROMs) is gaining momentum worldwide. However, a deep understanding of the mechanisms underpinning ePROM interventions that could inform their optimal design to improve health outcomes is needed.
OBJECTIVE: This study aims to identify the implicit mechanisms that underpin the effectiveness of ePROM interventions and develop program theories about how and when ePROM interventions improve health outcomes.
METHODS: A realist synthesis of the literature about ePROM interventions in cancer clinical care was performed. A conceptual framework of ePROM interventions was constructed to define the scope of the review and frame the initial program theories. Literature searches of Ovid MEDLINE, Ovid Embase, Scopus, and CINAHL, supplemented by citation tracking, were performed to identify relevant literature to develop, refine, and test program theories. Quality appraisal of relevant studies was performed using the Mixed Methods Appraisal Tool.
RESULTS: Overall, 61 studies were included in the realist synthesis: 15 (25%) mixed methods studies, 9 (15%) qualitative studies, 13 (21%) descriptive studies, 21 (34%) randomized controlled trials, and 3 (5%) quasi-experimental studies. In total, 3 initial program theories were developed regarding the salient components of ePROM interventions-remote self-reporting, real-time feedback to clinicians, and clinician-patient telecommunication. The refined theories posit that remote self-reporting enables patients to recognize and report symptoms accurately and empowers them to communicate these to clinicians, real-time feedback prompts clinicians to manage symptoms proactively, and clinician-patient telephone interactions and e-interactions between clinic encounters improve symptom management by reshaping how clinicians and patients communicate. However, the intervention may not achieve the intended benefit if ePROMs become a reminder to patients of their illness and are not meaningful to them and when real-time feedback to clinicians lacks relevance and increases the workload.
CONCLUSIONS: The key to improving health outcomes through ePROM interventions is enabling better symptom reporting and communication through remote symptom self-reporting, promoting proactive management of symptoms through real-time clinician feedback, and facilitating clinician-patient interactions. Patient engagement with self-reporting and clinician engagement in responding to feedback are vital and may reinforce each other in improving outcomes. Effective ePROM interventions might fundamentally alter how clinicians and patients interact between clinic encounters.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:25 |
|---|---|
| Enthalten in: |
Journal of medical Internet research - 25(2023) vom: 28. Nov., Seite e48483 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Govindaraj, Ramkumar [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 29.11.2023 Date Revised 10.01.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.2196/48483 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM36506789X |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM36506789X | ||
| 003 | DE-627 | ||
| 005 | 20240114233429.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.2196/48483 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1255.xml |
| 035 | |a (DE-627)NLM36506789X | ||
| 035 | |a (NLM)38015606 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Govindaraj, Ramkumar |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Assessing Patient-Reported Outcomes in Routine Cancer Clinical Care Using Electronic Administration and Telehealth Technologies |b Realist Synthesis of Potential Mechanisms for Improving Health Outcomes |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 29.11.2023 | ||
| 500 | |a Date Revised 10.01.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a ©Ramkumar Govindaraj, Meera Agar, David Currow, Tim Luckett. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 28.11.2023. | ||
| 520 | |a BACKGROUND: The routine measurement of patient-reported outcomes in cancer clinical care using electronic patient-reported outcome measures (ePROMs) is gaining momentum worldwide. However, a deep understanding of the mechanisms underpinning ePROM interventions that could inform their optimal design to improve health outcomes is needed | ||
| 520 | |a OBJECTIVE: This study aims to identify the implicit mechanisms that underpin the effectiveness of ePROM interventions and develop program theories about how and when ePROM interventions improve health outcomes | ||
| 520 | |a METHODS: A realist synthesis of the literature about ePROM interventions in cancer clinical care was performed. A conceptual framework of ePROM interventions was constructed to define the scope of the review and frame the initial program theories. Literature searches of Ovid MEDLINE, Ovid Embase, Scopus, and CINAHL, supplemented by citation tracking, were performed to identify relevant literature to develop, refine, and test program theories. Quality appraisal of relevant studies was performed using the Mixed Methods Appraisal Tool | ||
| 520 | |a RESULTS: Overall, 61 studies were included in the realist synthesis: 15 (25%) mixed methods studies, 9 (15%) qualitative studies, 13 (21%) descriptive studies, 21 (34%) randomized controlled trials, and 3 (5%) quasi-experimental studies. In total, 3 initial program theories were developed regarding the salient components of ePROM interventions-remote self-reporting, real-time feedback to clinicians, and clinician-patient telecommunication. The refined theories posit that remote self-reporting enables patients to recognize and report symptoms accurately and empowers them to communicate these to clinicians, real-time feedback prompts clinicians to manage symptoms proactively, and clinician-patient telephone interactions and e-interactions between clinic encounters improve symptom management by reshaping how clinicians and patients communicate. However, the intervention may not achieve the intended benefit if ePROMs become a reminder to patients of their illness and are not meaningful to them and when real-time feedback to clinicians lacks relevance and increases the workload | ||
| 520 | |a CONCLUSIONS: The key to improving health outcomes through ePROM interventions is enabling better symptom reporting and communication through remote symptom self-reporting, promoting proactive management of symptoms through real-time clinician feedback, and facilitating clinician-patient interactions. Patient engagement with self-reporting and clinician engagement in responding to feedback are vital and may reinforce each other in improving outcomes. Effective ePROM interventions might fundamentally alter how clinicians and patients interact between clinic encounters | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a PROM | |
| 650 | 4 | |a PROMs | |
| 650 | 4 | |a cancer | |
| 650 | 4 | |a eHealth | |
| 650 | 4 | |a ePROM | |
| 650 | 4 | |a electronic patient-reported outcome measure | |
| 650 | 4 | |a literature review | |
| 650 | 4 | |a mobile phone | |
| 650 | 4 | |a narrative review | |
| 650 | 4 | |a oncology | |
| 650 | 4 | |a outcome measure | |
| 650 | 4 | |a outcome measures | |
| 650 | 4 | |a patient reported | |
| 650 | 4 | |a patient-reported outcome measure | |
| 650 | 4 | |a realist | |
| 650 | 4 | |a realist synthesis | |
| 650 | 4 | |a review methodology | |
| 650 | 4 | |a review methods | |
| 650 | 4 | |a search strategy | |
| 650 | 4 | |a self-reporting | |
| 700 | 1 | |a Agar, Meera |e verfasserin |4 aut | |
| 700 | 1 | |a Currow, David |e verfasserin |4 aut | |
| 700 | 1 | |a Luckett, Tim |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Journal of medical Internet research |d 1999 |g 25(2023) vom: 28. Nov., Seite e48483 |w (DE-627)NLM116127104 |x 1438-8871 |7 nnns |
| 773 | 1 | 8 | |g volume:25 |g year:2023 |g day:28 |g month:11 |g pages:e48483 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.2196/48483 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 25 |j 2023 |b 28 |c 11 |h e48483 | ||