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Publication
Implementation of PROs in daily oncology care before and during the SARS-CoV-2 pandemic
Book - Dissertation
Subtitle:real world experience
We report on the implementation trajectory of PRO-registration over time. From its early proof of concept evaluation in which early transmission of health information (PROs) to a specialized care team, made access to health care more efficient. To the evaluation of an interactive PRO registration and management algorithm in an advanced (cancer) treatment setting. These retrospective analyses regarded patients treated with a single drug in different disease settings. We then evaluated an adapted algorithm - allowing for uniform toxicity registration (PROs) using a graded scale system – in a multi-centered prospective cohort analysis of patients commencing routine chemotherapy for various diseases. Finally, and during the SARS-CoV-2 pandemic, we amended the algorithm to screen for COVID19 specific symptoms in concert with toxicity registration and decentralized blood analyses. Results Initially we demonstrated readiness of these patients to interact remotely with the care team resulting in an efficient symptom control and higher treatment compliance. Later, with the AMTRA initiative, we demonstrated clinical usefulness in a multicenter cohort analysis, validity of a cross cutting set of symptoms and positive treatment-compliance effect. When the SARS-CoV-2 pandemic disrupted the centralized health care system, we used the amended system to decentralize triage of patients and to coordinate PCR testing for SARS-CoV-2. Moreover, the ePRO monitoring together with a decentralized blood analysis resulted in a continued clinical care and shorter “chair-time” for patients. Finally we demonstrated that although the ePRO-registration was well accepted, patients still preferred face to face consultations rather than a switch to tele-consultations. This remote way of conversing with the care team seems to be under-appreciated. Conclusions As electronic services are expanding, we need to appreciate the lessons we have learned during these trying SARS-CoV-2 times to allow for more research to determine the optimal use of technology for oncology visits as well as best practices and standards to ensure a consistent and continuous approach to cancer care delivery to all.
Number of pages: 120
Publication year:2023
Keywords:Doctoral thesis
Accessibility:Open