2883 - The Acceptability and Appropriateness of Routine ePRO Assessment among Patients with Metastatic Cancer in Radiation Oncology

Purpose/Objective(s): Symptom-directed radiation therapy among patients with metastatic cancer is often under-utilized. Electronic patient-reported outcomes (ePRO) monitoring has been associated with improved survival and care delivery of patients in medical oncology. Similarly, ePRO may help bridge communication between patients and providers to facilitate consideration of symptom-directed treatment in radiation oncology, although routine utilization of ePRO in the radiation oncology clinic is not well-studied. The purpose of the present study is to evaluate the patient-reported acceptability and appropriateness of ePRO assessment as a mechanism to potentially better manage symptoms including identification of patients who would benefit from palliative radiation therapy.

Materials/Methods: Adult patients with metastatic solid tumor malignancy undergoing evaluation with radiation oncology were enrolled on a prospective study assessing ePRO using multiple validated instruments. Participants were prompted to complete ePRO assessments at baseline, initial follow-up, and every 3 months for 1 year. Participants were invited to complete an optional assessment of patient-reported acceptability and appropriateness which were the co-primary outcomes of the present report. Composite scores for acceptability and appropriateness were derived from the sample mean of each 4-item assessment with two-sided 95% confidence interval (mean ± 1.96 × SE). A composite score of =4 out of a 5-point Likert-type scale was the prespecified threshold for significance. Survey completion rate was also evaluated at each timepoint. 

Results: 50 of 54 consecutive patients completed assessment of acceptability and appropriateness (Table 1). Significance for acceptability and appropriateness was met with mean composite scores of 4.29 (95% CI: 4.12, 4.46) and 4.39 (95% CI: 4.25, 4.53) respectively. Overall, 91% of participants completed at least 1 follow-up questionnaire and survey completion rate at each follow-up timepoint ranged from 64-76%. 

Conclusion: Routine ePRO evaluation of patients with metastatic cancer in radiation oncology is acceptable and appropriate per patient report. Next steps aim to utilize changes in ePRO to prompt consideration of timely palliative radiation. 

Table 1: Baseline characteristics and results of acceptability/appropriateness. Rate of survey completion at each time reported relative to number of active participants.