Adherence to daily electronic symptom screening in pediatric cancer: associations with time, location and pain.

Purpose: Regularly collected patient-reported outcome measures (PROMs) can facilitate early symptom detection and improve health outcomes. This explorative analysis aimed to investigate PROM adherence and factors associated with daily PROM completion among pediatric cancer patients.

Methods: We analyzed data from a prospective study at the Medical University of Innsbruck in which pediatric patients with cancer treated with chemotherapy completed daily PROMs via a web-based portal (ePROtect). We analyzed the PROM adherence during their first year of treatment descriptively and using a linear mixed model to evaluate factors associated with PROM adherence.

Results: Fifty patients (42% female) with a median age of 10.7 years (IQR 7.1-15.4) were included in this analysis (analysis period 05/2020 to 05/2023). The mean adherence was 48.7% (SD 27.2), with the highest adherence during the first 30 days (77.1%). Significant predictive factors for lower adherence included time in the program (logarithmic; β = -0.093, p < 0.001) and admission to the intensive care unit (β = -0.224, p < 0.001). In contrast, inpatient stays (β = 0.035, p = 0.014) and self-reported pain (β = 0.087, p = 0.002) were significant predictors for higher PROM adherence. Occurrences of adverse events were not significantly associated with adherence.

Discussion: Our findings suggest that continuous daily symptom monitoring is feasible over extended periods. PROM adherence stabilized over time despite an initial drop, with higher participation observed during inpatient stays and in weeks with self-reported pain. Future research should explore and evaluate strategies to improve adherence.