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Performance Measures Based on How Adults With Cancer Feel and Function: Stakeholder Recommendations and Feasibility Testing in Six Cancer Centers.
- Source :
- JCO Oncology Practice; Mar2020, Vol. 16 Issue 3, pe234-e250, 17p
- Publication Year :
- 2020
-
Abstract
- PURPOSE: Patient-reported outcome measures (PROMs) that assess how patients feel and function have potential for evaluating quality of care. Stakeholder recommendations for PRO-based performance measures (PMs) were elicited, and feasibility testing was conducted at six cancer centers. METHODS: Interviews were conducted with 124 stakeholders to determine priority symptoms and risk adjustment variables for PRO-PMs and perceived acceptability. Stakeholders included patients and advocates, caregivers, clinicians, administrators, and thought leaders. Feasibility testing was conducted in six cancer centers. Patients completed PROMs at home 5-15 days into a chemotherapy cycle. Feasibility was operationalized as ≥ 75% completed PROMs and ≥ 75% patient acceptability. RESULTS: Stakeholder priority PRO-PMs for systemic therapy were GI symptoms (diarrhea, constipation, nausea, vomiting), depression/anxiety, pain, insomnia, fatigue, dyspnea, physical function, and neuropathy. Recommended risk adjusters included demographics, insurance type, cancer type, comorbidities, emetic risk, and difficulty paying bills. In feasibility testing, 653 patients enrolled (approximately 110 per site), and 607 (93%) completed PROMs, which indicated high feasibility for home collection. The majority of patients (470 of 607; 77%) completed PROMs without a reminder call, and 137 (23%) of 607 completed them after a reminder call. Most patients (72%) completed PROMs through web, 17% paper, or 2% interactive voice response (automated call that verbally asked patient questions). For acceptability, > 95% of patients found PROM items to be easy to understand and complete. CONCLUSION: Clinicians, patients, and other stakeholders agree that PMs that are based on how patients feel and function would be an important addition to quality measurement. This study also shows that PRO-PMs can be feasibly captured at home during systemic therapy and are acceptable to patients. PRO-PMs may add value to the portfolio of PMs as oncology transitions from fee-for-service payment models to performance-based care that emphasizes outcome measures. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANXIETY treatment
TREATMENT of dyspnea
INSOMNIA treatment
NAUSEA treatment
VOMITING treatment
PAIN management
TREATMENT of peripheral neuropathy
CANCER chemotherapy
CANCER patients
CANCER treatment
CAREGIVERS
CLINICAL trials
CONSTIPATION
MENTAL depression
DIARRHEA
EXECUTIVES
GASTROINTESTINAL diseases
HOME care services
INTERVIEWING
RESEARCH methodology
MEDICAL quality control
HEALTH outcome assessment
PHYSICIANS
QUALITY assurance
SOCIOECONOMIC factors
SPECIALTY hospitals
ALCOHOL-induced disorders
PATIENTS' attitudes
DESCRIPTIVE statistics
STAKEHOLDER analysis
CANCER fatigue
SYMPTOMS
Subjects
Details
- Language :
- English
- ISSN :
- 26881527
- Volume :
- 16
- Issue :
- 3
- Database :
- Complementary Index
- Journal :
- JCO Oncology Practice
- Publication Type :
- Academic Journal
- Accession number :
- 142188506
- Full Text :
- https://doi.org/10.1200/JOP.19.00784