Aim: Patient-reported outcome measures (PROMs) provide important information about the impact of disease and treatment from the patient’s perspective. PROMs have traditionally been used in cancer clinical trials, but there is increasing interest in using PROMs in oncology settings in the management of individual patients. However, evidence suggests that the effectiveness of using PROMs in clinic is equivocal. Given this ambiguity, we aimed to determine the benefits and limitations of using PROMs in oncology clinical settings from patient and clinician perspectives.
Method: Systematic review searching AMED, Medline, Embase and PsychINFO from inception to November 2018. Qualitative studies examining patients’ and/or clinicians’ experiences of using PROMs in clinic were included. Study eligibility, data extraction and synthesis was performed independently by two reviewers. Discrepancies were discussed with the study team.
Results: Of the 1654 abstracts retrieved, 32 studies met eligibility. From these studies, seven themes were identified: active patient involvement (enables greater awareness and reflection, facilitates goal setting, influences (dis)honesty, permits discussion of sensitive topics); focus of consultation (narrows the focus, prioritizes patient needs); patient-doctor relationship (provides reassurance, inhibits interaction and rapport); quality of care (prompts action, enables holistic tailored care, inaccurately estimates the problem); standardized monitoring of patient outcomes over time (useful for monitoring treatment effectiveness and PRO changes); lacks valuable information (PROM not clinically meaningful, provides redundant information); not suitable for all patients (e.g. low literacy & cognitively impaired).
Conclusion: Both patients and clinicians experienced many benefits from using PROMs in clinical practice but also highlighted several limitations. These limitations shed some light on why PROM interventions may not always lead to an improvement in patient outcomes and provide important considerations that should be addressed in future PROM interventions in oncology clinical settings.