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. 2024 Feb 28;8(1):25.
doi: 10.1186/s41687-024-00687-y.

Use of patient-reported outcome measures after breast reconstruction in low- and middle-income countries: a scoping review

Sri Harshini Malapati  1 , Colby J Hyland  2 , George Liang  2 , Maria O Edelen  2 , Amanda Fazzalari  2 , Manraj N Kaur  2 , Paul A Bain  3 , Gita N Mody  4 , Andrea L Pusic  2
Affiliations

Use of patient-reported outcome measures after breast reconstruction in low- and middle-income countries: a scoping review

Sri Harshini Malapati et al. J Patient Rep Outcomes. .

Abstract

Background: Patient-reported outcome measures (PROMs) are increasingly administered in high-income countries to monitor health-related quality of life of breast cancer patients undergoing breast reconstruction. Although low- and middle-income countries (LMICs) face a disproportionate burden of breast cancer, little is known about the use of PROMs in LMICs. This scoping review aims to examine the use of PROMs after post-mastectomy breast reconstruction among patients with breast cancer in LMICs.

Methods: MEDLINE, Embase, Web of Science, CINAHL, and PsycINFO were searched in August 2022 for English-language studies using PROMs after breast reconstruction among patients with breast cancer in LMICs. Study screening and data extraction were completed. Data were analyzed descriptively.

Results: The search produced 1024 unique studies, 33 of which met inclusion criteria. Most were observational (48.5%) or retrospective (33.3%) studies. Studies were conducted in only 10 LMICs, with 60.5% in China and Brazil and none in low-income countries. Most were conducted in urban settings (84.8%) and outpatient clinics (57.6%), with 63.6% incorporating breast-specific PROMs and 33.3% including breast reconstruction-specific PROMs. Less than half (45.5%) used PROMs explicitly validated for their populations of interest. Only 21.2% reported PROM response rates, ranging from 43.1 to 96.9%. Barriers and facilitators of PROM use were infrequently noted.

Conclusions: Despite the importance of PROM collection and use in providing patient-centered care, it continues to be limited in middle-income countries and is not evident in low-income countries after breast reconstruction. Further research is necessary to determine effective methods to address the challenges of PROM use in LMICs.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
PRISMA diagram for included studies. PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Fig. 2
Fig. 2
Distribution of studies, by country. *Of note, 3 of the studies in China were conducted in Taiwan. Although Taiwan is technically considered China on a national level, the resources and income level of Taiwan may differ greatly from mainland China
See this image and copyright information in PMC

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