Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2019

Feasibility of collecting patient reported outcomes (PROs) from CALD populations: Experience of Arabic immigrants with cancer (#50)

Ivana Durcinoska 1 , Roya Merie 2 , Geoff P Delaney 1 2 3 , Afaf Girgis 1 3
  1. Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, UNSW Sydney, Sydney, New South Wales, Australia
  2. Liverpool Cancer Therapy Centre, Liverpool Hospital, Sydney, New South Wales, Australia
  3. South Western Sydney Clinical School, UNSW Sydney, Sydney, New South Wales, Australia

Background: Systematic monitoring of patient reported outcomes (PROs) is increasingly important in patient-centred care. However, widespread collection and integration into clinical practice remains a challenge, particularly among culturally and linguistically diverse (CALD) patients with limited English proficiency. This is the first study to compare the feasibility and acceptability of ePRO screening as part of routine clinical care among Arabic versus English-speaking patients diagnosed with cancer.

Methods: Patients receiving care at Liverpool and Wollongong Hospitals were recruited in clinic and invited to complete PRO assessments (Distress Thermometer and Problem List (DT), Edmonton Symptom Assessment Scale (ESAS-r)) in their preferred language on two occasions, 4 weeks apart, followed by an evaluation survey. Assessment #1 was completed on a tablet in-clinic, with option for completing Assessment #2 on a tablet or paper. A mixed method approach was used to evaluate feasibility and acceptability.   

Results: Overall, 55 patients (36% Arabic, 64% English speaking, mean age 62yrs, 67% female) completed 105 PRO assessments and 46 evaluation surveys. Satisfaction with the PRO assessment items varied between groups (50% Arabic, 75% English). Arabic speaking patients had difficulty understanding survey instructions (50%) and using the tablet (60%), with 95% requiring assistance to complete Assessment #1. Arabic patients expressed greater concern about privacy (22% vs 0%;p=0.02) and who would access and view responses (33% vs 4%;p=0.01). The majority (73%) of Arabic-speaking patients elected to complete Assessment #2 on paper, with 95% (19/20) indicating lack of regular access to or use of email to complete assessments outside of the clinic.

Conclusions: Sustainable implementation of PROs in clinical care is challenging. While acceptability and feasibility of implementing PRO screening was high among English-speaking patients, screening among Arabic-speaking patients presented several challenges. Development and evaluation of targeted strategies to better support CALD populations overcome these linguistic and cultural barriers is needed.