Background: PROMs are useful for identifying patient symptoms to guide supportive cancer care.
Aims: To determine whether electronic real-time PROMs administered prior to breast and thoracic oncology outpatient consultations are associated with supportive care and allied health referrals.
Methods: Oncology patients were invited to complete the EQ-5D-5L, Edmonton Symptom Assessment System-Revised, and Supportive Care Needs Survey-Short-Form (SCNS-SF34) electronically prior to scheduled appointments. Data were extracted from medical records for survey completers and non-completers. Between-group analyses were conducted using Chi-squared and t-tests.
Results: Data were extracted from 1,732 clinic consultations involving 677 patients (54% breast cancer, 46% lung cancer). PROMs participation was 69% in the breast cohort (mean age 62; 99% female; 61% metastatic; 993 referrals) and 65% in the lung cohort (mean age 68; 44% female; 72% metastatic; 739 referrals). The most common referrals were nursing (breast 77%, lung 85%), palliative care (breast 5.7%, lung 7.9%) and social work (breast 4.9%, lung 2.6%). For both cohorts, the likelihood of at least one supportive care referral was more common in consultations when PROMs were completed (breast 26.2%, lung 19.9%) than non-completed (breast 18.4%, lung 9.6%), all p<0.01.
Supportive care referrals were associated with lower self-rated health on the EQ-5D-5L VAS (breast M=63.8 vs 69.3; lung M=57.8 vs 64.0), both p=0.03. For breast cancer patients, supportive care referrals were related with higher anxiety/depression (M=2.1 vs 1.7, p<0.001) and usual activities (M=2.0 vs 1.8, p=0.03) scores for the EQ-5D-5L, and higher standardised summated scale scores for psychological, health system, patient care, and physical and daily living domains on the SCNS-SF34 (all p<0.001).
Conclusions: Completion of PROMs before breast and thoracic oncology consultations was associated with a greater likelihood of receiving nurse consultation and supportive care referrals. This analysis highlights the improved collaborative cancer care facilitated by routine implementation of PROMS in oncology consultations.