Using Implementation Science Frameworks to Guide the Use of Electronic Patient-Reported Outcome Symptom Monitoring in Routine Cancer Care

Lai-Kwon, J; Rutherford, C; Jefford, M; Gore, C; Best, S

Author(s): Lai-Kwon, J; Rutherford, C; Jefford, M; Gore, C; Best, S;
Details: Publication Year 2024-03,Volume 20,Issue #3,Page 335-349
Journal Title: JCO Oncology Practice
Publication Type: Research article
Abstract: PURPOSE: Electronic patient-reported outcomes (ePROs) are an evidence-based means of detecting symptoms earlier and improving patient outcomes. However, there are few examples of successful implementation in routine cancer care. We conducted a qualitative study to identify barriers and facilitators to implementing ePRO symptom monitoring in routine cancer care using the Consolidated Framework for Implementation Research (CFIR). METHODS: Participants were adult patients with cancer, their caregivers, or health care professionals involved in ePRO monitoring or processes. Focus groups or individual interviews were conducted using a semistructured approach informed by the CFIR. Data were analyzed deductively using the CFIR. Barriers were matched to theory-informed implementation strategies using the CFIR-Expert Recommendations for Implementing Change (ERIC) matching tool. RESULTS: Thirty participants were interviewed: 22 females (73%), aged 31-70 years (28, 94%), comprising patients (n = 8), caregivers (n = 2), medical oncologists (n = 4), nurses (n = 4), hospital leaders (n = 6), clinic administrators (n = 2), pharmacists (n = 2), and information technology specialists (n = 2). Barriers pertaining to four CFIR domains were identified and several were novel, including the challenge of adapting ePROs for different anticancer treatments. Facilitators pertaining to all CFIR domains were identified, such as leveraging acceptability of remote care post-COVID-19 to drive implementation. Conducting consensus discussions with stakeholders to tailor ePROs to the local setting, identifying/preparing individual and group-level champions, and assessing readiness for change (including leveraging technological advances and increased confidence in using remote monitoring post-COVID-19) were the most frequently recommended implementation strategies. CONCLUSION: The CFIR facilitated identification of known and novel barriers and facilitators to implementing ePRO symptom monitoring in routine cancer care. Implementation strategies summarized in a conceptual framework will be used to codesign an ePRO symptom monitoring system for immunotherapy side effects.
Publisher: American Society of Clinical Oncology
Keywords: Adult; Female; Humans; Implementation Science; Software; *COVID-19/epidemiology/therapy; Patient Reported Outcome Measures; Electronics; *Neoplasms/complications/therapy
Department(s): Medical Oncology; Health Services Research; Australian Cancer Survivorship Centre; Psychosocial Oncology
Publisher's Version: https://doi.org/10.1200/op.23.00462
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2024-04-04 03:09:37

Last Modified: 2024-04-04 03:11:20