The routine clinical use of electronic patient-reported outcome measures (ePROMs) for patients with lung cancer

Abstract

Background: The Christie NHS Foundation Trust launched their routine clinical ePROMs service in January 2019. The lung cancerspecific questionnaire consists of 14 symptom items, adapted from the CTCAE (v5.0) and the EuroQol EQ-5D-5L QoL tool. Both new and follow-up lung cancer patients are invited to complete questionnaires assessing their symptoms and QoL using an online platform called MyChristie-MyHealth. Methods: For patients who completed questionnaires between January 2019 and December 2020, the ePROM responses and clinical, pathological and treatment data were extracted from electronic medical records. The symptom and QoL scores of patients who completed baseline pre-treatment ePROMs and also those who completed ePROMs pre- and post- palliative lung systemic anticancer therapy (SACT) or radical thoracic radiotherapy were evaluated. Pre-treatment questionnaires were analysed based on age group, ECOG PS and ACE-27 comorbidity score. Results: The analysis included 1480 lung cancer patients. There were no statistically significant differences in symptom and QoL scores between age groups. Cough (p=0.006) and EQ-5D-5L mobility scores (p=0.006) were significantly worse for patients with an ECOG PS of 0-1. Dyspnoea (p=0.035), haemoptysis (p=0.023), nausea (p=0.041), mobility (p=0.004) and self-care (p=0.0420) were significantly worse for those with higher ACE-27 scores (2-3 vs. 0-1). Palliative SACT was associated with a significant improvement in cough (p=<0.001) and haemoptysis (p=0.025), but significantly negatively impacted mobility (p=0.013). Patients receiving radical thoracic radiotherapy reported a significant improvement in haemoptysis (p=0.042) but worse pain (p=0.002) and fatigue (p=0.01). Other changes in symptom and QoL scores were not significant. Conclusion: The symptom and QoL scores reported at baseline and pre- and post- both palliative SACT and radical thoracic radiotherapy are clinically relevant and meaningful. We have demonstrated that it is feasible to implement ePROMs into routine clinical practice and they have the potential to inform and transform clinical practice and future research. Disclosure: No significant relationships.