What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

doi:10.1186/s12913-020-4939-7

. 2020 Feb 10;20(1):102.

doi: 10.1186/s12913-020-4939-7.

What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

Bróna Nic Giolla Easpaig¹, Yvonne Tran², Mia Bierbaum², Gaston Arnolda², Geoff P Delaney^{3

4

5}, Winston Liauw^{6

7}, Robyn L Ward^{8

9}, Ian Olver¹⁰, David Currow^{11

12}, Afaf Girgis^{4

5}, Ivana Durcinoska^{4

5}, Jeffrey Braithwaite²

Affiliations

¹ Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2109, Australia. brona.nicgiollaeaspaig@mq.edu.au.
² Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2109, Australia.
³ Liverpool Cancer Therapy Centre, Liverpool, NSW, 2170, Australia.
⁴ South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, 2170, Australia.
⁵ Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
⁶ St. George Cancer Care Centre, St. George Hospital, Kogarah, NSW, 2217, Australia.
⁷ St. George Hospital Clinical School, University of New South Wales, Sydney, NSW, 2217, Australia.
⁸ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
⁹ Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.
¹⁰ Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia.
¹¹ College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia.
¹² Faculty of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia.

PMID: 32041593
PMCID: PMC7011235
DOI: 10.1186/s12913-020-4939-7

What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

Bróna Nic Giolla Easpaig et al. BMC Health Serv Res. 2020.

. 2020 Feb 10;20(1):102.

doi: 10.1186/s12913-020-4939-7.

Authors

Affiliations

¹ Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2109, Australia. brona.nicgiollaeaspaig@mq.edu.au.
² Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW, 2109, Australia.
³ Liverpool Cancer Therapy Centre, Liverpool, NSW, 2170, Australia.
⁴ South Western Sydney Clinical School, University of New South Wales, Liverpool, NSW, 2170, Australia.
⁵ Centre for Oncology Education and Research Translation (CONCERT), Ingham Institute for Applied Medical Research, Liverpool, NSW, 2170, Australia.
⁶ St. George Cancer Care Centre, St. George Hospital, Kogarah, NSW, 2217, Australia.
⁷ St. George Hospital Clinical School, University of New South Wales, Sydney, NSW, 2217, Australia.
⁸ Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
⁹ Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.
¹⁰ Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia.
¹¹ College of Medicine and Public Health, Flinders University, Adelaide, SA, 5042, Australia.
¹² Faculty of Health, University of Technology Sydney, Sydney, NSW, 2007, Australia.

PMID: 32041593
PMCID: PMC7011235
DOI: 10.1186/s12913-020-4939-7

Abstract

Background: The adoption of Patient Reported Outcome Measures (PROMs) in cancer care has been widely advocated, but little is known about the evidence for the implementation of PROMs in practice. Qualitative research captures the perspectives of health professionals as end-users of PROMs and can be used to inform adoption efforts. This paper presents a systematic review and synthesis of qualitative research conducted to address the question: What are the attitudes of health professionals towards PROMs in oncology, including any barriers and facilitators to the adoption of PROMS, reported in qualitative evidence?

Methods: Systematic searches of qualitative evidence were undertaken in four databases and reviewed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published in English between 1998 and 2018, which reported qualitative findings about the attitudes of health professionals working in oncology towards PROMs were eligible. Studies were assessed using the Critical Appraisal Skills Programme's Qualitative Research Checklist. A sentiment analysis was conducted on primary text to examine the polarity (neutral, positive or negative) of health professionals' views of PROMs. Qualitative meta-synthesis was conducted using a constant comparative analysis.

Results: From 1227 articles after duplicates were removed, with 1014 excluded against the screening criteria, 213 full text articles remained and were assessed; 34 studies met the inclusion criteria and were included. The majority of studies were of good quality. Sentiment analysis on primary text demonstrated an overall positive polarity from the expressed opinions of health professionals. The meta-synthesis showed health professionals' attitudes in four domains: identifying patient issues and needs using PROMs; managing and addressing patient issues; the care experience; and the integration of PROMs into clinical practice.

Conclusions: From the accounts of health professionals, the fit of PROMs with existing practice, how PROMs are valued, capacity to respond to PROMs and the supports in place, formed the key factors which may impede or promote adoption of PROMs in routine practice. To assist policy-makers and services involved in implementing these initiatives, further evidence is required about the relationship between PROMs data collection and corresponding clinical actions.

Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42019119447, 6th March, 2019.

Keywords: Health professional attitudes; Implementing practice change; Oncology; PROMs; Patient reported outcome measures; Qualitative synthesis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

**Fig. 1**
PRISMA [17] flowchart of search strategy

**Fig. 2**
Sentiment scores for HPs’ attitudes towards PROMs

**Fig. 3**
Themes identified regarding HPs’ attitudes towards PROMs

See this image and copyright information in PMC

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References

1. Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–565. doi: 10.1200/JCO.2015.63.0830. - DOI - PMC - PubMed
1. Luckett T, Butow PN, King MT. Improving patient outcomes through the routine use of patient-reported data in cancer clinics: future directions. Psychooncology. 2009;18(11):1129–1138. doi: 10.1002/pon.1545. - DOI - PubMed
1. Howell D, Wilkinson K, Molloy S, Green E, Liberty J, Orchard K, et al. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol. 2015;26(9):1846–1858. doi: 10.1093/annonc/mdv181. - DOI - PubMed
1. Williams K, Sansoni J, Morris D, Grootemaat P, Thompson CJ. Patient-reported outcome measures: literature review. Sydney: Australian Health Services Research Institute, University of Wollongong; 2016.
1. Chen J, Ou L, Hollis SJ. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res. 2013;13(1):211. doi: 10.1186/1472-6963-13-211. - DOI - PMC - PubMed

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[1] Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–565. doi: 10.1200/JCO.2015.63.0830. - DOI - PMC - PubMed

[2] Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–565. doi: 10.1200/JCO.2015.63.0830. - DOI - PMC - PubMed

[3] Luckett T, Butow PN, King MT. Improving patient outcomes through the routine use of patient-reported data in cancer clinics: future directions. Psychooncology. 2009;18(11):1129–1138. doi: 10.1002/pon.1545. - DOI - PubMed

[4] Luckett T, Butow PN, King MT. Improving patient outcomes through the routine use of patient-reported data in cancer clinics: future directions. Psychooncology. 2009;18(11):1129–1138. doi: 10.1002/pon.1545. - DOI - PubMed

[5] Howell D, Wilkinson K, Molloy S, Green E, Liberty J, Orchard K, et al. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol. 2015;26(9):1846–1858. doi: 10.1093/annonc/mdv181. - DOI - PubMed

[6] Howell D, Wilkinson K, Molloy S, Green E, Liberty J, Orchard K, et al. Patient-reported outcomes in routine cancer clinical practice: a scoping review of use, impact on health outcomes, and implementation factors. Ann Oncol. 2015;26(9):1846–1858. doi: 10.1093/annonc/mdv181. - DOI - PubMed

[7] Williams K, Sansoni J, Morris D, Grootemaat P, Thompson CJ. Patient-reported outcome measures: literature review. Sydney: Australian Health Services Research Institute, University of Wollongong; 2016.

[8] Williams K, Sansoni J, Morris D, Grootemaat P, Thompson CJ. Patient-reported outcome measures: literature review. Sydney: Australian Health Services Research Institute, University of Wollongong; 2016.

[9] Chen J, Ou L, Hollis SJ. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res. 2013;13(1):211. doi: 10.1186/1472-6963-13-211. - DOI - PMC - PubMed

[10] Chen J, Ou L, Hollis SJ. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res. 2013;13(1):211. doi: 10.1186/1472-6963-13-211. - DOI - PMC - PubMed

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What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

Affiliations

What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

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Cited by

References

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