Pharmacist-led interventions associated with symptoms identified by electronic patient-reported outcome battery: A descriptive study.

Abstract

IntroductionAt the University of California Irvine (UCI) in Orange County California, we published an implementation study to evaluate the use of an electronic patient-reported outcome (ePRO) tool to guide pharmacist-led chemotherapy education in newly diagnosed cancer patients. The goal of this secondary analysis was to describe the types of pharmacist-led interventions performed in the implementation study.MethodsUsing a pre-configured ePRO battery, patients' symptoms were assessed in seven domains (cognitive impairment, physical impairment, pain, depression, anxiety, fatigue, nausea/vomiting) at each infusion visit. Other symptoms that were brought up during the visit were also documented. Based on symptom scores calculated in real-time, pharmacists implemented personalized patient care strategies and documented them in the clinical notes. Descriptive statistics were employed to evaluate the type of interventions employed for each symptom domain.ResultsAmong 250 patients enrolled, the average age of participants was 60 years old (SD = 14.6), with 129 (52%) being female, and 134 (54%) of participants identified as white. The preconfigured ePRO battery identified clinically important symptoms at 47.3% of the visits, and other clinically important symptoms were identified at 23.4% of the visits. Pharmacist education was performed for 311 (55%) of 564 visits examined throughout the study. The highest proportions of pharmacological interventions were performed to manage nausea/vomiting (51 visits), followed by gastrointestinal symptoms (21 visits), and pain (16 visits). Additional provider communication was performed for managing nausea/vomiting (14 visits), pain (9 visits), and neurological symptoms (9 visits).ConclusionWe observed a high rate of pharmacist-led education after the institution of ePRO to evaluate symptoms in patients undergoing anticancer treatment. Future studies should consider incorporating additional ePRO domains to include a wide range of patient-reported symptoms tailored to each type of anticancer treatment.