Jessica Liu, Timothy B Baker, Jingling Chen, Nina Smock, Nicholas B Griffith, Ramaswamy Govindan, Paula Goldberg, Jodi Thole, Kristin Daly, James Reddy, Alex T Ramsey, Laura J Bierut, Aimee James, Robert A Schnoll, Ross C Brownson, Li-Shiun Chen
{"title":"患者产生的健康数据:对促进癌症患者以患者为中心的护理点烟草治疗的影响。","authors":"Jessica Liu, Timothy B Baker, Jingling Chen, Nina Smock, Nicholas B Griffith, Ramaswamy Govindan, Paula Goldberg, Jodi Thole, Kristin Daly, James Reddy, Alex T Ramsey, Laura J Bierut, Aimee James, Robert A Schnoll, Ross C Brownson, Li-Shiun Chen","doi":"10.1017/cts.2025.77","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Guideline-based tobacco treatment is infrequently offered. Electronic health record-enabled patient-generated health data (PGHD) has the potential to increase patient treatment engagement and satisfaction.</p><p><strong>Methods: </strong>We evaluated outcomes of a strategy to enable PGHD in a medical oncology clinic from July 1, 2021 to December 31, 2022. Among 12,777 patients, 82.1% received a tobacco screener about use and interest in treatment as part of eCheck-in via the patient portal.</p><p><strong>Results: </strong>We attained a broad reach (82.1%) and moderate response rate (30.9%) for this low-burden PGHD strategy. Patients reporting current smoking (<i>n</i> = 240) expressed interest in smoking cessation medication (47.9%) and counseling (35.8%). As a result of patient requests via PGHD, most tobacco treatment requests by patients were addressed by their providers (40.6-80.3%). Among patients with active smoking, those who received/answered the screener (<i>n</i> = 309 ) were more likely to receive tobacco treatment compared with usual care patients who did not have the patient portal (<i>n</i> = 323) (OR = 2.72, 95% CI = 1.93-3.82, <i>P</i> < 0.0001) using propensity scores to adjust for the effect of age, sex, race, insurance, and comorbidity. Patients who received yet ignored the screener (<i>n</i> = 1024) compared with usual care were also more likely to receive tobacco treatment, but to a lesser extent (OR = 2.20, 95% CI = 1.68-2.86, <i>P</i> < 0.0001). We mapped observed and potential benefits to the Translational Science Benefits Model (TSBM).</p><p><strong>Discussion: </strong>PGHD via patient portal appears to be a feasible, acceptable, scalable, and cost-effective approach to promote patient-centered care and tobacco treatment in cancer patients. 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Electronic health record-enabled patient-generated health data (PGHD) has the potential to increase patient treatment engagement and satisfaction.</p><p><strong>Methods: </strong>We evaluated outcomes of a strategy to enable PGHD in a medical oncology clinic from July 1, 2021 to December 31, 2022. Among 12,777 patients, 82.1% received a tobacco screener about use and interest in treatment as part of eCheck-in via the patient portal.</p><p><strong>Results: </strong>We attained a broad reach (82.1%) and moderate response rate (30.9%) for this low-burden PGHD strategy. Patients reporting current smoking (<i>n</i> = 240) expressed interest in smoking cessation medication (47.9%) and counseling (35.8%). As a result of patient requests via PGHD, most tobacco treatment requests by patients were addressed by their providers (40.6-80.3%). Among patients with active smoking, those who received/answered the screener (<i>n</i> = 309 ) were more likely to receive tobacco treatment compared with usual care patients who did not have the patient portal (<i>n</i> = 323) (OR = 2.72, 95% CI = 1.93-3.82, <i>P</i> < 0.0001) using propensity scores to adjust for the effect of age, sex, race, insurance, and comorbidity. Patients who received yet ignored the screener (<i>n</i> = 1024) compared with usual care were also more likely to receive tobacco treatment, but to a lesser extent (OR = 2.20, 95% CI = 1.68-2.86, <i>P</i> < 0.0001). We mapped observed and potential benefits to the Translational Science Benefits Model (TSBM).</p><p><strong>Discussion: </strong>PGHD via patient portal appears to be a feasible, acceptable, scalable, and cost-effective approach to promote patient-centered care and tobacco treatment in cancer patients. 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引用次数: 0
摘要
引言:很少提供基于指南的烟草治疗。支持电子健康记录的患者生成的健康数据(PGHD)有可能提高患者的治疗参与度和满意度。方法:我们评估了2021年7月1日至2022年12月31日在肿瘤内科诊所实施PGHD策略的结果。在12777名患者中,82.1%的人通过患者门户网站接受了关于使用和治疗兴趣的烟草筛查,作为eccheck -in的一部分。结果:我们获得了广泛的覆盖范围(82.1%)和中等的缓解率(30.9%),这种低负担的PGHD策略。报告目前吸烟的患者(n = 240)表示对戒烟药物(47.9%)和咨询(35.8%)感兴趣。由于患者通过PGHD提出请求,大多数患者的烟草治疗请求由其提供者处理(40.6-80.3%)。在积极吸烟的患者中,接受或回答筛查的患者(n = 309)比没有患者门户的常规护理患者(n = 323)更有可能接受烟草治疗(OR = 2.72, 95% CI = 1.93-3.82, P < 0.0001),使用倾向评分来调整年龄、性别、种族、保险和合共病的影响。与常规治疗相比,接受筛查但忽略筛查的患者(n = 1024)也更有可能接受烟草治疗,但程度较低(OR = 2.20, 95% CI = 1.68-2.86, P < 0.0001)。我们将观察到的和潜在的效益映射到转化科学效益模型(TSBM)中。讨论:通过患者门户网站进行PGHD似乎是一种可行的、可接受的、可扩展的、具有成本效益的方法,可以促进癌症患者以患者为中心的护理和烟草治疗。重要的是,PGHD方法是利用TSBM预防癌症的一个现实例子。
Patient-generated health data: Impact on promoting patient-centered point of care tobacco treatment in patients with cancer.
Introduction: Guideline-based tobacco treatment is infrequently offered. Electronic health record-enabled patient-generated health data (PGHD) has the potential to increase patient treatment engagement and satisfaction.
Methods: We evaluated outcomes of a strategy to enable PGHD in a medical oncology clinic from July 1, 2021 to December 31, 2022. Among 12,777 patients, 82.1% received a tobacco screener about use and interest in treatment as part of eCheck-in via the patient portal.
Results: We attained a broad reach (82.1%) and moderate response rate (30.9%) for this low-burden PGHD strategy. Patients reporting current smoking (n = 240) expressed interest in smoking cessation medication (47.9%) and counseling (35.8%). As a result of patient requests via PGHD, most tobacco treatment requests by patients were addressed by their providers (40.6-80.3%). Among patients with active smoking, those who received/answered the screener (n = 309 ) were more likely to receive tobacco treatment compared with usual care patients who did not have the patient portal (n = 323) (OR = 2.72, 95% CI = 1.93-3.82, P < 0.0001) using propensity scores to adjust for the effect of age, sex, race, insurance, and comorbidity. Patients who received yet ignored the screener (n = 1024) compared with usual care were also more likely to receive tobacco treatment, but to a lesser extent (OR = 2.20, 95% CI = 1.68-2.86, P < 0.0001). We mapped observed and potential benefits to the Translational Science Benefits Model (TSBM).
Discussion: PGHD via patient portal appears to be a feasible, acceptable, scalable, and cost-effective approach to promote patient-centered care and tobacco treatment in cancer patients. Importantly, the PGHD approach serves as a real world example of cancer prevention leveraging the TSBM.