Summary of studies
| Author, publication year, country, number of participants (n). | Clinical setting | Monitoring | PROM feedback mechanism (intervention group) |
|---|---|---|---|
| Anderson 2015,17 USA, n=60 | Outpatient oncology. Breast cancer | Automated telephone monitoring twice weekly for 8 weeks | Oncologist emailed if symptom reached thresholds. Symptom summaries given to oncologists before scheduled appointments |
| Aubin 2006,19 Canada, n=80 | Community palliative care. Mixed cancer types | Twice daily paper diary for 4 weeks | Patient instructed to contact their nurse if pain or analgesic use reached a set threshold. Nurse liaised with prescribing physician |
| Berry 2011,20 USA, n=660 (ESRA-C 1 intervention) | Outpatient oncology. Mixed cancer types | Preclinic on touch screen notebook computers on 2 occasions | Colour graphical summaries handed to the clinician before appointments or attached to clinical notes |
| Berry 2014,21 USA, n=752 (ESRA-C 2 intervention) | Outpatient oncology. mixed cancer types | Internet-based form (completed at home or on clinic PCs) at 3 points over 8 weeks | Symptoms above a threshold automatically produced tailored coaching messages on how to describe the problem to the clinical team. PROM graphs and coaching messages could be viewed by the patient at any time |
| Bertsche 2009,23 Germany, n=100 | Inpatient oncology. Mixed cancer types | Daily inpatient assessment | Pain scores linked to algorithmic pain management instructions |
| Cleeland 2011,18 USA, n=100 | Postoperative outpatient. Primary lung cancer or lung metastases | Twice weekly automated telephone calls for 4 weeks | An email alert was sent to the advanced nurse practitioner if any symptoms were above a threshold. |
| De Wit 2001,24 the Netherlands, n=313, and Van Der Peet,44 2009, the Netherlands, n=120 | Community palliative care. Mixed cancer types | Twice daily paper pain diary for 2 months | Patient's knowledge, attitude and pain ratings used to tailor education and advice about non-pharmacological strategies |
| Du Pen 1999,26 USA, n=81 | Outpatient oncology. Mixed cancer types | Daily paper diary for 3 months | Pain ratings, side effects and analgesic use mapped to algorithmic pain management guidelines for physicians |
| Given 2004,27 USA, n=237 | Outpatient oncology. Mixed cancer types | Fortnightly report to nurse (face-to-face and by telephone) over 20 weeks | Symptoms above a threshold lead the nurse to provide specific self-management instructions and coaching |
| Hoekstra 2006,28 the Netherlands, n=146 | Outpatient oncology. Breast cancer | Weekly ratings in a paper booklet | Patients were asked to bring the symptom monitor booklet to all clinical appointments. |
| Kravitz 2011,29–32 USA, n=307 | Outpatient oncology and palliative care. Recurrent or metastatic lung, breast, and upper gastrointestinal cancers | Questionnaire administered by telephone by a health educator on a single occasion prior to a clinic appointment | Health educator met with patients an hour before clinic appointments and used their PROM data to provide tailored pain education, correcting misconceptions, teaching self-management strategies and how to communicate with the physician. |
| Kroenke 2010,33 USA, n=405 | Outpatient oncology. Mixed cancer types | Automated telephone or online, twice weekly to monthly over 12 months | Nurse reviewed symptom reports, liaised with the patient's oncologist and contacted the patient with treatment recommendations. |
| Miaskowski 2004,34 USA, n=174 and Rustoen 2014,39 Norway, n=179 (PRO-SELF intervention) | Outpatient oncology. Cancer with bony metastases | Daily paper diary for 6 weeks | PROM data used to tailor education and coaching. Patients taught to use a weekly pill box, and to use a specific script to communicate with their physician about unrelieved pain and the need for a change in their medication. |
| Mooney 2014,35 USA, n=250 | Outpatient oncology. Mixed cancer types | Daily automated telephone assessment for 45 days | Automated alerts faxed or emailed to the patient's oncologist or nurse if symptoms or trends in symptoms reached a threshold. |
| Post 2013,36 USA, n=50 | Outpatient oncology. Breast cancer | Weekly on a PDA over 160 days. | Patients asked to view videos on the PDA about how to communicate about symptoms and to bring the PDA to clinic appointments. Professionals viewed symptom summaries on the PDA and a printed output was added to clinic notes. |
| Ruland 2010,37 Norway, n=145 (CHOICE ITPA intervention) | Inpatient and outpatient oncology. Haematological malignancies | Preclinic assessments and daily during inpatient admissions over 1 year | Symptom summaries printed and added to clinical notes to be reviewed by the treating physician |
| Trowbridge 1997,40 USA, n=510 | Outpatient oncology. Recurrent or metastatic cancer | Questionnaire immediately before a clinic appointment | Summary sheet provided to oncologist before the appointment |
| Vallières 2006,41 Canada, n=64 | Outpatient radiation oncology. Mixed cancer types | Twice daily paper diary at home for 3 weeks | Participants asked to bring their diary to scheduled clinic appointments. Participants asked to seek medical attention if pain intensity scores or analgesic use reached a predetermined threshold |
| Velikova 2004,42 UK, n=286 | Outpatient oncology. Mixed cancer types | Touch screen questionnaires in the waiting room before appointments for 6 months | Specific symptoms and functional outcomes were displayed individually and tracked longitudinally on graphs provided to the patient's physician. |
| Wilkie 2010,45 USA, n=215 | Outpatient oncology. Lung cancer | Greased pencil on a laminated pain tool on a daily basis | Patients watched a video on how to monitor and report changes in pain, and encouraged to summarise their pain ratings in note form to help them verbally report pain at scheduled appointments. |
PDA, personal digital assistant; PROM, patient-reported outcome measurement.