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Feasibility and acceptability of electronic symptom surveillance with clinician feedback using the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in Danish prostate cancer patients

  • Baeksted, Christina1, 2
  • Pappot, Helle2
  • Nissen, Aase1
  • Hjollund, Niels Henrik3, 4
  • Mitchell, Sandra A.5
  • Basch, Ethan6
  • Bidstrup, Pernille Envold7
  • Dalton, Susanne Oksbjerg7
  • Johansen, Christoffer2, 7
  • 1 Documentation & Quality, Danish Cancer Society, Strandboulevarden 49, Copenhagen, DK-2100, Denmark , Copenhagen (Denmark)
  • 2 The Finsen Centre, Rigshospitalet, Department of Oncology, Blegdamsvej 9, Copenhagen, DK-2100, Denmark , Copenhagen (Denmark)
  • 3 Aarhus University Hospital, Department of Clinical Epidemiology, Olof Palmes Allé 43-45, Aarhus, DK-8200, Denmark , Aarhus (Denmark)
  • 4 Aarhus University, WestChronic, Department of Occupational Medicine, University Clinic, Health, Gl. Landevej 61, Herning, DK-7400, Denmark , Herning (Denmark)
  • 5 National Cancer Institute, Outcomes Research Branch, Division of Cancer Control and Population Sciences, 9609 Medical Center Drive, 3 East Suite 448, Rockville, MD, 20850, USA , Rockville (United States)
  • 6 Cancer Outcomes Research Program, UNC Lineberger Comprehensive Cancer Center, 101 Manning Dr, Chapel Hill, NC, 27514, USA , Chapel Hill (United States)
  • 7 Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, Copenhagen, DK-2100, Denmark , Copenhagen (Denmark)
Published Article
Journal of Patient-Reported Outcomes
Springer International Publishing
Publication Date
Sep 12, 2017
DOI: 10.1186/s41687-017-0005-6
Springer Nature


BackgroundThe aim was to examine the feasibility, acceptability and clinical utility of electronic symptom surveillance with clinician feedback using a subset of items drawn from the Patient-Reported Outcomes version of Common Terminology Criteria for Adverse Events (PRO-CTCAE) in a cancer treatment setting.MethodsDanish-speaking men with castration-resistant metastatic prostate cancer receiving treatment at the Department of Oncology, Rigshospitalet, Copenhagen between March 9, 2015 and June 8, 2015 were invited to participate (n = 63 eligible). Participants completed the PRO-CTCAE questionnaire on tablet computers using AmbuFlex software at each treatment visit in the outpatient clinic. In total, 22 symptomatic toxicities (41 PRO-CTCAE items), corresponding to the symptomatic adverse-events profile associated with the regimens commonly used for prostate cancer treatment (Docetaxel, Cabazitaxel, Abiraterone, Alpharadin), were selected. Participants’ PRO-CTCAE responses were presented graphically to their treating oncologists via an AmbuFlex dashboard, for real-time use to enhance the patient-clinician dialogue that occurs during the consultation prior to each treatment cycle. Technical and clinical barriers and acceptability were evaluated through semi-structured interviews with both patients and oncologists. Patients receiving active treatment at the end of the study period completed an evaluation questionnaire.ResultsFifty-four out of sixty-three (86%) eligible patients were enrolled. The PRO-CTCAE questionnaire was completed a total of 168 times by 54 participants (median number per patient was 3, range 1–5). Eight surveys were missed, resulting in a compliance rate of 97%. At the end of the study period, 35 patients (65%) were still receiving active treatment and completed the evaluation questionnaire. Patients reported that their PRO-CTCAE responses served as a communication tool. Oncologists stated that the availability of the PRO-CTCAE self-reports during the consultation improved patient-clinician communication about side effects.ConclusionElectronic capture of symptomatic toxicities using PRO-CTCAE and the submission of self-reports to clinicians prior to consultation were feasible among metastatic prostate cancer patients receiving chemotherapy in an outpatient setting, and this procedure was acceptable to both patients and clinicians. Continued research, including a cluster-randomized trial, will evaluate the effects of submitting patients’ PRO-CTCAE results to clinicians prior to consultation on the quality of side-effects management and resultant clinical outcomes.

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