What Are Patient-Reported Outcomes?

Patient-reported outcomes is information that patients directly report about their health status regarding a certain disease condition and treatment they are undergoing. The healthcare professionals are not involved in the process of this reporting but receive these reports and can respond accordingly. The patients are most often given a questionnaire to record various parameters. The parameters can be related to symptoms they are experiencing, their general ability to do daily activities, quality of life and some questions more specific to the condition.

Mostly, patient-reported outcomes were used in clinical trials since it helps get personal feedback from the patients about a new treatment apart from the follow-ups in the hospitals. However, with digitalization, implementing these measures outside of clinical trials is promising and real-time monitoring is possible.

Why Are Patient-Reported Outcomes Required in Cancer Treatment?

Cancer affects millions around the world yearly and the burden of new cancer cases is only increasing. With new cancer treatments often involving oral medications to be taken at home, patients need to take more responsibilities in their health management. This also means that any side effects or symptoms resulting from the medication, or the disease needs to be monitored at home and then reported. The quality of life of cancer patients has also always been an issue. Finally, with the number of cancer patients increasing, there is potential for a shortage of healthcare providers. This will demand alternate patient care management.

Digital Health Solution to Patient-Reported Outcomes

In helping solve the above-stated issues, patient-centered care which is supportive and integrates treatment information is also required. This could help in improving the survival rate and more importantly the quality of life. Ideally, by providing good patient management, the cost of the healthcare involved can also be reduced.

As indicated by the review article, there are a lot of digital health solutions collecting patient-reported outcome measures that are being tested now. These are in the form of smartphone apps or web-based solutions. These solutions have one or multiple features of the following: symptom recording, monitoring vitals (like blood pressure, heart rate) through wearables, personalized interaction tailored to the treatment, knowledge sharing, telemedicine or other communication features, monitoring mental health status, and assessing quality of life.

What Are the Benefits and Problems of Adopting These Solutions?

The major benefits that encourage the patients to adopt and use these solutions are the ease of use, patients feeling empowered, ability to report symptoms in real time and to communicate with healthcare providers, receiving system alerts, and responses to the alerts. However, there are barriers to using these digital interventions. This includes difficulty in using technology, poor connectivity, finding its usefulness limited, and lack of clarity.

What Is the Evidence That These Solutions Work in Cancer Treatment?

In a report that looked at multiple clinical studies using digital patient-reported outcomes, the authors found that patients benefited from this digital reporting by a reduction in cancer-related fatigue and depression and improved quality of living. Similarly, multiple other studies reported reduced severity of symptoms, depression, and distress. In a different study, an internet-based exercise program was introduced to a sub-group of patients and compared them to patients who were not involved in the exercise program. The patients who were doing the exercise program reported better overall health, physical health, and cognitive function.

To test whether the self-reporting by the patients was accurate, a recent study asked cancer patients to report their nutrition status (since nutritional deterioration is a problem in cancer) and other parameters. When compared to the nutrition risk assessed by a dietician, this self-nutrition report was 89% in agreement. This proved that self-reporting by patients works. Interestingly, 38.2% of participants also asked for nutrition intervention on the same day of identifying an issue.

Different studies showed that using digital health solutions also helped in increasing the overall survival rate by 5 to 8 months. This was probably helped through faster interventions when required due to the reporting by the patient. This overall survival rate has to be studied further and through different interventions.

Future of Digital Health Solutions in Cancer

The advantages of digital patient-reported outcomes are immense. Imagine being treated for a sudden side-effect or symptom of cancer treatment without delay because of real-time monitoring of the patient through their reports and through wearables that monitor vital parameters like blood pressure and breathing rate. These digital health solutions are already being developed but have to be tested and go through different trials. To have a higher adoption rate by patients, the healthcare practitioners will also have to commit to it with their time and use of technology. Further, the hospitals will have to integrate these reports into their system ensuring that data privacy and security are maintained. Lastly, even with these interventions, patients and doctors must ensure that in-person communication is maintained.