TY - JOUR
T1 - Performance measures based on how adults with cancer feel and function
T2 - Stakeholder recommendations and feasibility testing in six cancer centers
AU - Stover, Angela M.
AU - Urick, Benjamin Y.
AU - Deal, Allison M.
AU - Teal, Randall
AU - Vu, Maihan B.
AU - Carda-Auten, Jessica
AU - Jansen, Jennifer
AU - Chung, Arlene E.
AU - Bennett, Antonia V.
AU - Chiang, Anne
AU - Cleeland, Charles
AU - Deutsch, Yehuda
AU - Tai, Edmund
AU - Zylla, Dylan
AU - Williams, Loretta A.
AU - Pitzen, Collette
AU - Snyder, Claire
AU - Reeve, Bryce
AU - Smith, Tenbroeck
AU - McNiff, Kristen
AU - Cella, David
AU - Neuss, Michael N.
AU - Miller, Robert
AU - Atkinson, Thomas M.
AU - Spears, Patricia A.
AU - Smith, Mary Lou
AU - Geoghegan, Cindy
AU - Basch, Ethan M.
N1 - Publisher Copyright:
© 2020 by American Society of Clinical Oncology.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - 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.
AB - 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.
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U2 - 10.1200/JOP.19.00784
DO - 10.1200/JOP.19.00784
M3 - Article
C2 - 32074014
AN - SCOPUS:85084228908
SN - 1554-7477
VL - 16
SP - E234-E250
JO - Journal of oncology practice
JF - Journal of oncology practice
IS - 3
ER -