Perceived Barriers Toward Patient-Reported Outcome Implementation in Cancer Care: An International Scoping Survey

Lawson Eng, Raymond J. Chan, Alexandre Chan, Andreas Charalambous, H. S. Darling, Lisa Grech, Corina J.G. van den Hurk, Deborah Kirk, Sandra A. Mitchell, Dagmara Poprawski, Elke Rammant, Imogen Ramsey, Margaret I. Fitch, Yin Ting Cheung

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

PURPOSE 

Implementation of patient-reported outcomes (PROs) collection is an important priority in cancer care. We examined perceived barriers toward implementing PRO collection between centers with and without PRO infrastructure and administrators and nonadministrators. 

PATIENTS AND METHODS

We performed a multinational survey of oncology practitioners on their perceived barriers to PRO implementations. Multivariable regression models evaluated for differences in perceived barriers to PRO implementation between groups, adjusted for demographic and institutional variables. 

RESULTS 

Among 358 oncology practitioners representing six geographic regions, 31% worked at centers that did not have PRO infrastructure and 26% self-reported as administrators. Administrators were more likely to perceive concerns with liability issues (aOR, 2.00 [95% CI, 1.12 to 3.57]; P 5 .02) while having nonsignificant trend toward less likely perceiving concerns with disruption of workflow (aOR, 0.58 [95% CI, 0.32 to 1.03]; P 5 .06) and nonadherence of PRO reporting (aOR, 0.53 [95% CI, 0.26 to 1.08]; P 5 .08) as barriers. Respondents from centers without PRO infrastructure were more likely to perceive that not having access to a local PRO expert (aOR, 6.59 [95% CI, 3.81 to 11.42]; P < .001), being unsure how to apply PROs in clinical decisions (aOR, 4.20 [95% CI, 2.32 to 7.63]; P < .001), and being unsure about selecting PRO measures (aOR, 3.36 [95% CI, 2.00 to 5.66]; P < .001) as barriers. Heat map analyses identified the largest differences between participants from centers with and without PRO infrastructure in agreed-upon barriers were (1) not having a local PRO expert, (2) being unsure about selecting PRO measures, and (3) not recognizing the role of PROs at the institutional level. 

CONCLUSION 

Perceived barriers toward PRO implementation differ between administrators and nonadministrators and practitioners at centers with and without PRO infrastructure. PRO implementation teams should consider as part of a comprehensive strategy including frontline clinicians and administrators and members with PRO experience within teams.

Original languageEnglish
Pages (from-to)816-826
Number of pages11
JournalJCO Oncology Practice
Volume20
Issue number6
Early online date8 Mar 2024
DOIs
Publication statusPublished - Jun 2024

Keywords

  • cancer care
  • patient outcomes

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