Pharmacist-facilitated Patient Reported Outcome Measure (PROM) monitoring: developing an EHR SmartForm© to monitor side effects of oral oncolytics during routine telehealth encounters.
IF 3.3
3区 医学
Q1 HEALTH CARE SCIENCES & SERVICES
Angela M Stover, Debbie Liang, Dana Mueller, Rachel Kurtzman, Christiana Ikemeh, Courtney Canter, Sonali Acharya, Jill Brese, Kaitlyn Buhlinger, Kevin Chen, Evan W Colmenares, Aimee Faso, Benyam Muluneh, Bianka Patel, Jeffrey S Reichard, Rushabh M Shah, Michael Tilkens, John Valgus, Lorinda A Coombs, Jennifer Elston Lafata, Jennifer L Lund, Emily M Ray, Gita Mody, Mary-Haston Vest
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Abstract
Purpose: Patient reported outcome measures (PROMs) are increasingly used in oncology care, but pharmacists providing direct patient care have been overlooked. We engaged pharmacists and adults receiving oral oncolytics (chemotherapy medication taken by mouth) to develop a SmartForm© in the electronic health record (EHR) for PROM monitoring. Pharmacists verbally ask the patient side effect questions during routine telehealth encounters and enter responses in real time.
Methods: Our development process was guided by the Knowledge to Action Framework. In phase 1 (Knowledge Inquiry), we prioritized side effects to assess in the EHR SmartForm© via interviews with patients and a Delphi panel with pharmacists. Adults receiving oral oncolytics for breast (n = 12), thoracic (n = 12), or hematological (n = 12) cancer were interviewed, with purposeful sampling for adults who were aged 65 + years or Black. Interviews were coded with content analysis. We conducted three Delphi rounds, with 11/19, 13/19, and 19/19 pharmacists, respectively. In phase 2 (Knowledge Synthesis), PROM items were selected and the EHR SmartForm© programmed. In phase 3 (Knowledge Tailoring), we conducted usability testing with pharmacists.
Results: Pharmacists and patients were consistent in prioritizing side effects of oral oncolytics and 10 were retained. Patients advocated asking whether they can do their usual activities, while pharmacists added medication adherence. Usability testing yielded suggestions to simplify the SmartForm©.
Conclusion: By presenting screenshots of our SmartForm©, our findings are useful to other healthcare systems looking for a PROM solution integrated in the EHR, with a reasonable pharmacist/clinician workload, and no requirement for patients to have internet access/comfort.
药剂师协助的患者报告结果测量(PROM)监测:开发 EHR SmartForm©,用于在常规远程医疗会诊期间监测口服溶瘤药的副作用。
目的:患者报告结果测量(PROMs)在肿瘤治疗中的应用越来越广泛,但提供直接患者护理的药剂师却被忽视了。我们让药剂师和接受口服溶瘤药(口服化疗药物)的成人参与进来,在电子病历 (EHR) 中开发了用于监测 PROM 的 SmartForm©。药剂师在日常远程医疗会诊中口头询问患者副作用问题,并实时输入回复:我们的开发过程以 "从知识到行动框架 "为指导。在第一阶段(知识探究),我们通过与患者的访谈和与药剂师的德尔菲小组讨论,确定了 EHR SmartForm© 中要评估的副作用的优先次序。我们对接受口服溶瘤药物治疗乳腺癌(12 人)、胸腺癌(12 人)或血癌(12 人)的成人进行了访谈,并有目的地抽取了 65 岁以上的成人或黑人。访谈采用内容分析法进行编码。我们分别与 11/19、13/19 和 19/19 名药剂师进行了三轮德尔菲讨论。在第 2 阶段(知识综合),我们选择了 PROM 项目并对 EHR SmartForm© 进行了编程。在第 3 阶段(知识定制),我们对药剂师进行了可用性测试:结果:药剂师和患者在优先考虑口服溶瘤药副作用方面意见一致,保留了 10 项副作用。患者主张询问他们是否可以进行日常活动,而药剂师则增加了用药依从性的内容。可用性测试提出了简化智能表的建议:通过展示我们的 SmartForm© 的截图,我们的研究结果对其他医疗保健系统寻找集成在电子病历中的 PROM 解决方案很有帮助,药剂师/临床医师的工作量合理,而且不要求患者能够上网/感觉舒适。
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来源期刊
期刊介绍:
Quality of Life Research is an international, multidisciplinary journal devoted to the rapid communication of original research, theoretical articles and methodological reports related to the field of quality of life, in all the health sciences. The journal also offers editorials, literature, book and software reviews, correspondence and abstracts of conferences.
Quality of life has become a prominent issue in biometry, philosophy, social science, clinical medicine, health services and outcomes research. The journal''s scope reflects the wide application of quality of life assessment and research in the biological and social sciences. All original work is subject to peer review for originality, scientific quality and relevance to a broad readership.
This is an official journal of the International Society of Quality of Life Research.