在肿瘤治疗中实施远程症状监测路径:法国和比利时 33 个癌症中心的实际经验分析

IF 13.6 Q1 HEALTH CARE SCIENCES & SERVICES
Maria Alice Franzoi , Arlindo R. Ferreira , Antoine Lemaire , Joseph Rodriguez , Jessica Grosjean , Joana M. Ribeiro , Laura Polastro , Thomas Grellety , Xavier Artignan , Katell Le Du , Martina Pagliuca , Élodie Nouhaud , Maximilien Autheman , Fabrice André , Ethan Basch , Otto Metzger , Charles Ferté , Mario Di Palma , Florian Scotté , Ines Vaz-Luis
{"title":"在肿瘤治疗中实施远程症状监测路径:法国和比利时 33 个癌症中心的实际经验分析","authors":"Maria Alice Franzoi ,&nbsp;Arlindo R. Ferreira ,&nbsp;Antoine Lemaire ,&nbsp;Joseph Rodriguez ,&nbsp;Jessica Grosjean ,&nbsp;Joana M. Ribeiro ,&nbsp;Laura Polastro ,&nbsp;Thomas Grellety ,&nbsp;Xavier Artignan ,&nbsp;Katell Le Du ,&nbsp;Martina Pagliuca ,&nbsp;Élodie Nouhaud ,&nbsp;Maximilien Autheman ,&nbsp;Fabrice André ,&nbsp;Ethan Basch ,&nbsp;Otto Metzger ,&nbsp;Charles Ferté ,&nbsp;Mario Di Palma ,&nbsp;Florian Scotté ,&nbsp;Ines Vaz-Luis","doi":"10.1016/j.lanepe.2024.101005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice. However, implementation in routine care has been slow and faces several challenges. In this study we report on the real-world multi-center implementation of a RPM pathway encompassing weekly patient symptom ePRO reporting with electronic alert notifications triggered to providers for severe or worsening symptoms.</p></div><div><h3>Methods</h3><p>An RPM pathway was implemented in 33 European cancer centers in France and Belgium between November 2021 and August 2023. The implementation process followed a standardized phasic process of Exploration, Preparation, Implementation and Sustainment. Patient-level and system-level implementation metrics were collected and evaluated according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.</p></div><div><h3>Findings</h3><p>Across the 33 cancer centers, the RPM pathway was implemented for 3015 patients cared for by 168 providers. The RPM pathway enabled effective and timely symptom management with 94.6% of all alerts (10,132/10,711) evolving to an improvement two weeks later, among which 88.4% (9468/10,711) showed ≥2 grades of improvement on the 5-point scale of the Patient-Reported Outcomes Common Terminology (PRO-CTCAE). The median time to alert management by the care team was 13 h 41 min (25th percentile: 1 h 42 min, 75th percentile: 1 day + 19 h 54 min), with 80% (36,269/45,334) of alerts managed by a nurse navigator telephone call. Patient adherence with weekly ePRO reporting was 82% (2472/3015). In an experience survey, 87% (32/38) of providers were satisfied with integrating the solution into their organization and 90% (276/307) of the patients felt that ePRO reporting positively impacted their care. As of March 2024, the pathway has been maintained in all participating centers, with activation of an additional 18 centers following data lock, and reimbursement for this RPM pathway approved in France in October 2023.</p></div><div><h3>Interpretation</h3><p>These findings demonstrate the feasibility of implementing and maintaining an RPM pathway during routine care across a diverse group of cancer centers in the European setting, with high levels of patient and provider engagement, and positive clinical impact.</p></div><div><h3>Funding</h3><p>Part of this work was funded <span>Breast Cancer Research Foundation</span> (Career Development Award to Maria Alice Franzoi) and Resilience (nurse navigation and technology support).</p></div>","PeriodicalId":53223,"journal":{"name":"Lancet Regional Health-Europe","volume":null,"pages":null},"PeriodicalIF":13.6000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666776224001728/pdfft?md5=50069cac5954bd3fa98d23568fd366a6&pid=1-s2.0-S2666776224001728-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium\",\"authors\":\"Maria Alice Franzoi ,&nbsp;Arlindo R. Ferreira ,&nbsp;Antoine Lemaire ,&nbsp;Joseph Rodriguez ,&nbsp;Jessica Grosjean ,&nbsp;Joana M. Ribeiro ,&nbsp;Laura Polastro ,&nbsp;Thomas Grellety ,&nbsp;Xavier Artignan ,&nbsp;Katell Le Du ,&nbsp;Martina Pagliuca ,&nbsp;Élodie Nouhaud ,&nbsp;Maximilien Autheman ,&nbsp;Fabrice André ,&nbsp;Ethan Basch ,&nbsp;Otto Metzger ,&nbsp;Charles Ferté ,&nbsp;Mario Di Palma ,&nbsp;Florian Scotté ,&nbsp;Ines Vaz-Luis\",\"doi\":\"10.1016/j.lanepe.2024.101005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice. However, implementation in routine care has been slow and faces several challenges. In this study we report on the real-world multi-center implementation of a RPM pathway encompassing weekly patient symptom ePRO reporting with electronic alert notifications triggered to providers for severe or worsening symptoms.</p></div><div><h3>Methods</h3><p>An RPM pathway was implemented in 33 European cancer centers in France and Belgium between November 2021 and August 2023. The implementation process followed a standardized phasic process of Exploration, Preparation, Implementation and Sustainment. Patient-level and system-level implementation metrics were collected and evaluated according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.</p></div><div><h3>Findings</h3><p>Across the 33 cancer centers, the RPM pathway was implemented for 3015 patients cared for by 168 providers. The RPM pathway enabled effective and timely symptom management with 94.6% of all alerts (10,132/10,711) evolving to an improvement two weeks later, among which 88.4% (9468/10,711) showed ≥2 grades of improvement on the 5-point scale of the Patient-Reported Outcomes Common Terminology (PRO-CTCAE). The median time to alert management by the care team was 13 h 41 min (25th percentile: 1 h 42 min, 75th percentile: 1 day + 19 h 54 min), with 80% (36,269/45,334) of alerts managed by a nurse navigator telephone call. Patient adherence with weekly ePRO reporting was 82% (2472/3015). In an experience survey, 87% (32/38) of providers were satisfied with integrating the solution into their organization and 90% (276/307) of the patients felt that ePRO reporting positively impacted their care. As of March 2024, the pathway has been maintained in all participating centers, with activation of an additional 18 centers following data lock, and reimbursement for this RPM pathway approved in France in October 2023.</p></div><div><h3>Interpretation</h3><p>These findings demonstrate the feasibility of implementing and maintaining an RPM pathway during routine care across a diverse group of cancer centers in the European setting, with high levels of patient and provider engagement, and positive clinical impact.</p></div><div><h3>Funding</h3><p>Part of this work was funded <span>Breast Cancer Research Foundation</span> (Career Development Award to Maria Alice Franzoi) and Resilience (nurse navigation and technology support).</p></div>\",\"PeriodicalId\":53223,\"journal\":{\"name\":\"Lancet Regional Health-Europe\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":13.6000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666776224001728/pdfft?md5=50069cac5954bd3fa98d23568fd366a6&pid=1-s2.0-S2666776224001728-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Lancet Regional Health-Europe\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666776224001728\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lancet Regional Health-Europe","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666776224001728","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 0

摘要

背景使用电子患者报告结果(ePROs)对症状进行远程患者监测(RPM)已被证明可以减轻症状负担、减少住院治疗、提高剂量强度并改善患者在系统治疗期间的生活质量,国际指南已将其推荐为常规肿瘤治疗方法。然而,在常规治疗中的实施进展缓慢,并面临着一些挑战。在本研究中,我们报告了多中心实际实施 RPM 途径的情况,包括每周报告患者症状 ePRO,并在症状严重或恶化时向医疗服务提供者发出电子警报通知。方法在 2021 年 11 月至 2023 年 8 月期间,在法国和比利时的 33 个欧洲癌症中心实施了 RPM 途径。实施过程遵循 "探索"、"准备"、"实施 "和 "维持 "的标准化阶段性流程。研究结果在 33 个癌症中心中,168 名医疗服务提供者为 3015 名患者实施了 RPM 途径。RPM路径实现了有效、及时的症状管理,94.6%的警报(10132/10711)在两周后得到改善,其中88.4%的警报(9468/10711)在患者报告结果通用术语(PRO-CTCAE)的5级评分中显示出≥2级的改善。护理团队处理警报的中位时间为 13 小时 41 分钟(第 25 百分位数:1 小时 42 分钟,第 75 百分位数:1 天 + 19 小时 54 分钟),80%(36269/45334)的警报由护士导航员电话处理。患者对每周 ePRO 报告的依从性为 82%(2472/3015)。在体验调查中,87%(32/38)的医疗服务提供者对将该解决方案整合到其组织中表示满意,90%(276/307)的患者认为 ePRO 报告对其护理产生了积极影响。截至 2024 年 3 月,所有参与中心都保留了这一路径,另有 18 个中心在数据锁定后启动了这一路径,法国于 2023 年 10 月批准了对这一 RPM 路径的报销。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Implementation of a remote symptom monitoring pathway in oncology care: analysis of real-world experience across 33 cancer centres in France and Belgium

Background

Remote patient monitoring (RPM) of symptoms using electronic patient reported outcomes (ePROs) has been shown to reduce symptom burden and hospitalizations, increase dose intensity and improve quality of life of patients during systemic therapy being recommended by international guidelines in routine oncology practice. However, implementation in routine care has been slow and faces several challenges. In this study we report on the real-world multi-center implementation of a RPM pathway encompassing weekly patient symptom ePRO reporting with electronic alert notifications triggered to providers for severe or worsening symptoms.

Methods

An RPM pathway was implemented in 33 European cancer centers in France and Belgium between November 2021 and August 2023. The implementation process followed a standardized phasic process of Exploration, Preparation, Implementation and Sustainment. Patient-level and system-level implementation metrics were collected and evaluated according to the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework.

Findings

Across the 33 cancer centers, the RPM pathway was implemented for 3015 patients cared for by 168 providers. The RPM pathway enabled effective and timely symptom management with 94.6% of all alerts (10,132/10,711) evolving to an improvement two weeks later, among which 88.4% (9468/10,711) showed ≥2 grades of improvement on the 5-point scale of the Patient-Reported Outcomes Common Terminology (PRO-CTCAE). The median time to alert management by the care team was 13 h 41 min (25th percentile: 1 h 42 min, 75th percentile: 1 day + 19 h 54 min), with 80% (36,269/45,334) of alerts managed by a nurse navigator telephone call. Patient adherence with weekly ePRO reporting was 82% (2472/3015). In an experience survey, 87% (32/38) of providers were satisfied with integrating the solution into their organization and 90% (276/307) of the patients felt that ePRO reporting positively impacted their care. As of March 2024, the pathway has been maintained in all participating centers, with activation of an additional 18 centers following data lock, and reimbursement for this RPM pathway approved in France in October 2023.

Interpretation

These findings demonstrate the feasibility of implementing and maintaining an RPM pathway during routine care across a diverse group of cancer centers in the European setting, with high levels of patient and provider engagement, and positive clinical impact.

Funding

Part of this work was funded Breast Cancer Research Foundation (Career Development Award to Maria Alice Franzoi) and Resilience (nurse navigation and technology support).

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
19.90
自引率
1.40%
发文量
260
审稿时长
9 weeks
期刊介绍: The Lancet Regional Health – Europe, a gold open access journal, is part of The Lancet's global effort to promote healthcare quality and accessibility worldwide. It focuses on advancing clinical practice and health policy in the European region to enhance health outcomes. The journal publishes high-quality original research advocating changes in clinical practice and health policy. It also includes reviews, commentaries, and opinion pieces on regional health topics, such as infection and disease prevention, healthy aging, and reducing health disparities.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信