Initial findings following the routine implementation of electronic patient reported outcome measures (ePROMs) for patients with lung cancer at the Christie NHS Foundation Trust

Abstract

Introduction: The Christie NHS Foundation Trust introduced ePROMs routinely for all patients with lung cancer in January 2019. Patients remotely complete a questionnaire assessing symptoms and quality of life (QoL) using an online platform ‘My Christie-My Health’. The results are used to offer patients symptom advice, if applicable, and help clinicians to better guide consultations. Methods: The demographic information and ePROM responses for lung cancer patients who completed the questionnaires between January 2019 and December 2020 at the Christie were extracted from electronic medical records. The resulting database was then manually cleaned. Differences in reported symptoms and QoL measures pre and post palliative systemic anticancer therapy (SACT) and radical thoracic radiotherapy were compared using Wilcoxon signed rank tests on the statistical software JASP 0.13.1. Questionnaires were considered pre-treatment if they were completed up to a maximum of one month before treatment started. Post-treatment questionnaires differed according to the treatment type i.e., for SACT = from day one up to three weeks after completion and for radiotherapy = halfway through the treatment course up to six weeks after completion. Results: Figure 1 displays the details of our findings. Palliative lung SACT was associated with a significant improvement in cough (Figure Presented)Fig. 1. Patient demographic information and the breakdown of the ePROM responses based on treatment type. ACE, Adult Co-morbidity Evaluation; ECOG, Eastern Co-operative Oncology Group; PS, performance status; hx, history; NSCLC, non-small cell lung cancer. ePROMS, electronic patient-reported outcome measures; SACT, systemic anticancer therapy; RT, radiotherapy; cCRT, concurrent chemoradiotherapy; QoL, quality of life.(p=<0.001) and coughing up blood (p=0.025), but significantly impacted mobility (p=0.013). Patients receiving radical thoracic radiotherapy also reported a significant improvement in coughing up blood (p=0.042) but worse pain (p=0.002) and tiredness (p=0.01). Other changes in symptoms and QoL after SACT or radiotherapy were not significant. Conclusion: The ePROM questionnaire used routinely at the Christie NHS Foundation Trust in patients with lung cancer demonstrates adequate validity, as these changes in symptoms and QoL are in keeping with those expected following palliative SACT and radical thoracic radiotherapy