Patient-reported symptoms increased Quality of Life!
Cancer therapies can significantly affect the quality of life (QoL) of patients and a proper description of subjective symptoms is crucial and necessary for the proper management. Studies showed that an adequate collection of subjective symptoms from the patients is strictly related to the outcome.
The patient-reported outcomes (PROs), which require a targeted discussion with the patient, in order to reduce the risk of under-reporting, are the gold standard to describe their subjective symptoms. Several studies have shown underestimation of the incidence of patients’ symptoms and the presence and severity of each side effect by the clinician. A PRO is the direct report of a patient’s condition, not interpreted nor modified from a clinician.
In the study: «The role of patient-reported outcomes in outpatients receiving active anti-cancer treatment: impact on patients’ quality of life», published in Supportive Care, the assessment of patient-reported symptoms and toxicities in patients who received active anti-cancer therapy was introduced in the routine clinical practice, in the out-patient setting.
The patients received a questionnaire by an oncology nurse to provide information about their symptoms and toxicities. The role of the dedicated nurse was fundamental in the introduction of PROs in the project. They educated the patient about the purpose and the importance of the self-reporting of their symptoms and provided instructions about the proper way to fill in the questionnaires. Then the nurse collected the questionnaires and delivered them to the physician. All patients completed two EORTC QLQ-C30 questionnaires (1) upon first visit and (2) one month later.
Significantly better global mean changes for fatigue, pain, and appetite loss were recorded, compared to the traditional modality of visit and patients expressed high satisfaction (92%). Patients found the questionnaire to self-record their symptoms a valid instrument to improve communication with the physician. The positive impact on global QoL and symptoms was relatively fast and was observed a few weeks after the initiation of the observation period.
The authors pointed out that the role of the dedicated nurses was fundamental to introduce the PROs in the routine clinical practice. Nurses administered the questionnaires, explained their objective and the proper way of filling and delivered them to the clinician before the visit.
The introduction of PROs in clinical practice, with the active role of the nurses, was feasible, associated with a high grade of patients’ satisfaction, and also related to a significant QoL improvement, compared to the traditional modality of visit. These results encourage the wide application of PROs in clinical practice, as it is also strongly suggested by a growing body of evidence in recent years.
Baratelli C, et al. The role of patient-reported outcomes in outpatients receiving active anti-cancer treatment: impact on patients’ quality of life. Supportive Care in Cancer 2019;27:4697-4704