A controlled study of use of patient-reported outcomes to improve assessment of late effects after treatment for head-and-neck cancer

作者：Kjaer Trille; Dalton Susanne Ok**jerg; Andersen Elo; Karlsen Randi; Nielsen Anni Linnet; Hansen Merete Kjaer; Frederiksen Kirsten; Johansen Christoffer

来源：Radiotherapy and Oncology, 2016, 119(2): 221-228.

DOI：10.1016/j.radonc.2016.04.034

• Head-and-neck cancer
• Patient-reported outcomes
• Late effects

Background and purpose: To test the effect of longitudinal feedback on late effects reported by survivors of head-and-neck cancer (HNC) to clinicians during regular follow-up.
Material and methods: A total of 266 participants were sequentially assigned to either control or intervention group and filled in electronic versions of the EORTC QLQ C-30, H&N35, HADS and a study-specific list of symptoms at up to two consecutive follow-up visits. Participants' symptoms displayed according to severity were provided to the clinician for the intervention group but not for the control group.
Linear mixed-effects models were used to examine the number of symptoms assessed by clinicians (primary outcome). Multivariate linear regression models examined participants' long-term symptom control and QoL (secondary outcome).
Results: More symptoms were assessed by clinicians in the intervention group at all three visits (P < 0.001, <0.001, and P = 0.04). No effect was observed on most patient outcomes. When prompted by patient-reported outcomes at consultations, clinicians and patients were in better agreement about the occurrence of severe symptoms at all three visits.
Conclusion: Timely patient-reported outcomes to clinicians in routine follow-up of HNC survivors enhanced clinicians' rates of assessment of late symptoms. Giving reports of patient-reported outcome to clinicians had limited impact on participants' QoL or symptom burden.

• 出版日期2016-5