Oliver, Lauren 
ORCID: 0000-0001-5816-5498, Hutton, Danny, Cain, M, Bates, M, Mullen, E, Kirby, Mike ORCID: 0000-0001-9765-5641 and Cree, A
(2022)
Patient reported outcome measures (PROMs) in Radiotherapy: Qualitative results of a survey of healthcare professionals.
[Poster]
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Abstract
Background: Radiotherapy provides an effective treatment modality in the management of various malignancies. However, many patients develop acute and long-term toxicities that present a significant burden to their quality of life1,2. Such toxicities are often underreported by clinicians, and therefore patient-reported outcome measures(PROMs) present a more robust assessment3. Despite the clear advantages of PROMs including stratified follow-up and evaluation of clinical effectiveness, safety and cost, barriers exist at patient, healthcare professional(HCP) and service levels3,4. Most commonly, perceived lack of time/PROMs training for HCPS, poor IT infrastructure and lack of PROMs integration into existing systems create barriers3. The NHS England Radiotherapy Service Specification calls for routine use of PROMS, which requires effective implementation within radiotherapy5. Several ‘enablers’ to PROMs implementation have been identified, including use of electronic PROMs, automatic data interpretation and HCP training3,4,6. This study aimed to identify current PROMs use within radiotherapy nationally, to evaluate current attitudes, barriers and enablers to PROMs use, and to develop practical recommendations to implement PROMs within UK radiotherapy services. The qualitative findings are presented here. Methods: An e-questionnaire consisting of 12 open and multiple-choice questions was developed. The questionnaire was piloted by radiotherapy professionals, and disseminated via email across all radiotherapy operational delivery network(ODN) managers, covering the entirety of England. 182 participants were recruited across a range of professions including therapeutic radiographers, nurses and researchers. A mixed-methods approach was utilised; thematic analysis of free-text responses provided qualitative data, whilst statistical analysis was performed on quantitative results. Results: Inductive thematic analysis of questionnaire responses resulted in identification of key themes related to the barriers and enablers of PROMs use within radiotherapy. Interestingly, identical themes emerged associated with participants’ perceptions of both barriers/enablers, with an additional theme identified pertaining to potential enablers of PROMs: Barriers - Themes: 1. I.T. Infrastructure 2. Time 3. Resources(Human/Financial) 4. Training/Education Enablers - Themes: 1. I.T. Infrastructure 2. Time 3. Resources(Human/Financial) 4. Training/Education 5. Standardisation Conclusion: Our findings further demonstrate the paucity of routine PROMs use within radiotherapy. Here, we provide recommendations to mitigate barriers and implement PROMs; such steps include HCP training on PROMs and development/integration of electronic systems. Standardisation of PROMs tools and centralised data storage is essential to assessing radiotherapy toxicity data nationally and informing practice. Referral pathways to existing specialist services are fundamental to ensuring PROMs data are used meaningfully. This study provides an important first step in driving PROMs implementation within UK radiotherapy services. References 1. Miller, K., Nogueira, L., Mariotto, A., Rowland, J., Yabroff, R., Alfano, C., et al. (2019). Cancer treatment and survivorship statistics 2019. CA: A Cancer Journal For Clincians. https://doi.org/10.3322/caac.21565 2. Macmillan Cancer Support. Cured – but at what cost? Long-term consequences of cancer and its treatment. [ Internet] (2013). Available at: https://www.macmillan.org.uk/documents/aboutus/newsroom/consequences_of_treatment_june2013.pdf [Accessed online 28th March 2021]. 3. Nguyen, H., Butow, P., Dhillon, H. & Sundaresan, P. (2020a). A review of the barriers to using Patient-Reported Outcomes (PROs) and Patient-Reported Outcome Measures (PROMs) in routine cancer care. Journal of Medical Radiation Sciences. 00, 1-10. Doi: 10.1002/jmrs.421 4. Kingsley, C. & Patel, S. (2017). Patient-reported outcome measures and patient-reported experience measures. British Journal of Anaesthesia. 17, 137-144. doi: 10.1093/bjaed/mkw060 5. National Health Service (NHS) England (2019). Service Specification 170091S: Adult External Beam Radiotherapy Services Delivered as Part of a Radiotherapy Network. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/01/External-Beam-Radiotherapy-Services-Delivered-as-Part-of-a-Radiotherapy-Network-Adults.pdf [Accessed online 10th April 2021]. 6. Howell, D., Molloy, S., Wilkinson, K., Green, E., Orchard, K., Wang, K. & Liberty, J. (2015). Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Annals of Oncology. 26, 1846-1858. doi: 10.1093/annonc/mdv181
| Item Type: | Poster |
|---|---|
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Population Health Faculty of Health and Life Sciences > Institute of Population Health > School of Health Sciences |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 21 Apr 2022 07:48 |
| Last Modified: | 18 Jan 2023 21:04 |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3153530 |
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