JMIR Publications

ABSTRACT

Background:

The PATIENT VOICES system is a software developed to promote the systematic collection of electronic patient-reported outcome measures (ePROMs) in routine oncology clinical practice.

Objective:

This study aimed to test the feasibility of such a system, assessing patient compliance and analysing patient-related barriers to ePROMs implementation in a comprehensive cancer centre.

Methods:

Consecutive cancer patients attending three outpatient clinics and three inpatient wards were screened for eligibility (adult, native-speakers, and being able to fill in the ePROMs) and enrolled in a convergent quantitative and qualitative mixed-method study. Compliance, reasons for non-completion, patients' interaction needs and patient perceived System Usability Scale (SUS, range 0-100) were collected; semi-structured interviews were carried out in a subsample of patients.

Results:

Among 435 patients screened, 309 completed the ePROMs (73.4%; 95%CI 69.8% to 77.5%). Organization problems and patient refusal were the main reasons for non-completion among outpatients (17.1%) and inpatients (21.9%), respectively. Help for tablet usage was needed by 10.7% of inpatients and 27.8% of outpatients, while the support received for item interpretation was similar in the two groups (18.6% and 21.3%). Average SUS scores indicated high usability in both groups (86.8 and 83.9). Overall repeated measurement compliance (out-patients only) was 76.9%. Interviewed patients showed positive attitudes towards ePROMs, yet major barriers to implementation emerged about time and cognitive burden to complete the questionnaires, and perceived irrelevance of ePROMs.

Conclusions:

This study provides useful information for future ePROM implementation strategies, aimed at effectively supporting the routine clinical management and care of cancer patients. Also, these findings may be relevant to other organisations willing to systematically collect PROMs/ePROMs in their clinical routines.