在胰腺癌患者的多学科肿瘤委员会讨论中实施 ePRO:INSPIRE 干预。

IF 14.8 2区 医学 Q1 ONCOLOGY
Nicole L Henderson, Etzael Ortiz-Olguin, Garrett Bourne, Cameron Pywell, J Bart Rose, Grant R Williams, Ryan D Nipp, Gabrielle B Rocque
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引用次数: 0

摘要

背景:在胰腺癌的决策过程中纳入电子患者报告结果(ePRO),如老年评估(GA)和治疗偏好,一直受到临床医生和系统层面工作流程障碍的限制。我们假设,将 ePRO 纳入多学科肿瘤委员会(MDTB)将能规避障碍,并为系统考虑患者提供的关键信息提供场所:整合系统患者报告评估(INSPIRE)干预包括:(1)完成患者调查,包括GA和患者偏好;(2)在MDTB中筛选共享患者的ePRO。对 Proctor 等人的实施结果进行了评估,其中渗透率(在 MDTB 上获得同意的患者比例)是主要结果(成功率达到 70%)。次要结果包括采用率、可行性、可接受性、适宜性、成本和可持续性,通过临床医生 MDTB 后退出调查、临床医生干预后调查、临床医生干预后半结构式访谈,以及对记录和转录的历史(2021 年 11 月至 2022 年 2 月)和干预(2022 年 9 月至 2023 年 6 月)MDTB 进行时间编码分析来评估:共有 50 名患者完成了调查,所有患者都参加了 MDTB(普及率=100%)。所有符合条件的临床医生(人数=9)都登记了患者(采用率=100%),并报告说90%的患者使用了ePRO,30%的患者改变了治疗方案。在干预后的调查和访谈中,临床医生主要对可行性、可接受性和适宜性问题做出了积极回应。时间编码分析发现,干预前(平均值 [SD] 为 172.7 [111.4] 秒)和干预后(平均值 [SD] 为 223.8 [107.1] 秒)每位患者的平均讨论时间增加了 51.1 秒,时间成本并不高。所有接受调查的临床医生都表示有兴趣继续进行干预,并建议进行调整以进一步促进可持续性:将 ePRO 纳入胰腺癌 MDTB 是可行且可接受的,为临床团队在管理胰腺癌患者时更多地使用 ePRO 提供了一种潜在的方法。
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 ePROs Into Multidisciplinary Tumor Board Discussions for Patients With Pancreatic Cancer: The INSPIRE Intervention.

Background: The incorporation of electronic patient-reported outcomes (ePROs), such as the Geriatric Assessment (GA) and treatment preferences, into decision-making for pancreatic cancer has been limited by clinician- and system-level barriers concerning workflow. We hypothesized that ePRO inclusion within multidisciplinary tumor boards (MDTBs) would circumvent barriers and provide a venue for systematic consideration of critical patient-provided information.

Patients and methods: The INtegrating Systematic PatIent-Reported Evaluations (INSPIRE) intervention consists of (1) patient survey completion, including GA and patient preferences, and (2) screensharing patient ePROs during MDTBs. Proctor et al's implementation outcomes were assessed, with penetration (the proportion of consented patients who were presented at MDTBs) acting as the primary outcome (considered successful at 70%). Secondary outcomes included adoption, feasibility, acceptability, appropriateness, cost, and sustainability, assessed by clinician post-MDTB exit surveys, clinician postintervention surveys, clinician postintervention semistructured interviews, and time-coding analysis of recorded and transcribed historical (November 2021-February 2022) and intervention (September 2022-June 2023) MDTBs.

Results: A total of 50 patients completed surveys and all were presented at MDTBs (penetration=100%). All eligible clinicians (n=9) enrolled patients (adoption=100%) and reported that ePROs were useful in 90% and led to a change in treatment plan in 30% of cases. In postintervention surveys and interviews, clinicians primarily responded positively to feasibility, acceptability, and appropriateness questions. Time-coding analysis found a modest time cost of an additional 51.1 seconds in mean discussion time-per-patient between preintervention (mean [SD], 172.7 [111.4] seconds) and intervention patients (mean [SD], 223.8 [107.1] seconds); 86% of clinicians reported the intervention did not take too much time. All surveyed clinicians reported interest in continuing the intervention and suggested adaptations to further promote sustainability.

Conclusions: The integration of ePROs into pancreatic MDTBs was feasible and acceptable, providing a potential approach to increase the utilization of ePROs by clinical teams in their management of patients with pancreatic cancer.

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来源期刊
CiteScore
20.20
自引率
0.00%
发文量
388
审稿时长
4-8 weeks
期刊介绍: JNCCN—Journal of the National Comprehensive Cancer Network is a peer-reviewed medical journal read by over 25,000 oncologists and cancer care professionals nationwide. This indexed publication delivers the latest insights into best clinical practices, oncology health services research, and translational medicine. Notably, JNCCN provides updates on the NCCN Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), review articles elaborating on guideline recommendations, health services research, and case reports that spotlight molecular insights in patient care. Guided by its vision, JNCCN seeks to advance the mission of NCCN by serving as the primary resource for information on NCCN Guidelines®, innovation in translational medicine, and scientific studies related to oncology health services research. This encompasses quality care and value, bioethics, comparative and cost effectiveness, public policy, and interventional research on supportive care and survivorship. JNCCN boasts indexing by prominent databases such as MEDLINE/PubMed, Chemical Abstracts, Embase, EmCare, and Scopus, reinforcing its standing as a reputable source for comprehensive information in the field of oncology.
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