JMIR Publications

ABSTRACT

Background:

Routine electronic assessment of patient-reported outcomes (ePRO) can improve cancer care, yet its implementation in routine practice and long-term sustainability remain unclear. Understanding these aspects is critical to advancing the field.

Objective:

To review and describe the past and current status, time trends and the long-term sustainability of clinical ePRO applications in routine oncology care.

Methods:

We conducted a systematic review of publications on ePRO use in oncology care up to December 31, 2023, extracting data on clinical ePRO applications. A follow-up survey was sent to authors of published ePRO applications to assess their current use. Data were analyzed using descriptive statistics and regression models to evaluate time trends, with year of publication as the predictor.

Results:

Of 2,933 references screened, 303 met inclusion criteria. Publications increased significantly over time (2003–2023, P < .001). Trends showed a rise in mobile application use (OR = 1.211, P < .001), remote assessments (OR = 1.094, P = .002), and feedback provided to patients (OR = 1.060, P = .036). The survey had a 35.3% response rate (78/221), with 61.1% of ePRO applications still in use, lasting a median of 5 years. The most common reason for discontinuation was a lack of funding and resources (42.9%, 12/28).

Conclusions:

The field of ePRO assessment in oncology is growing, and shifting towards remote and app-based assessment, as well as increasingly providing feedback to patients. We present, for the first time, data on sustainability of ePRO use in routine care and show that financial and resource barriers remain a key challenge to sustainable implementations.