Patient Reported Outcomes/QoL/Survivorship

SS 09 - Patient Reported Outcomes/Quality of Life/Survivorship

65 - Comparison of Provider - Versus Patient-Reported Late and Long-Term Effects (LLTEs) Following Cancer Treatment: Results From an Internet-Based Survivorship Care Plan (SCP) Tool

Monday, October 22
7:45 AM - 7:55 AM
Location: Room 008

Comparison of Provider - Versus Patient-Reported Late and Long-Term Effects (LLTEs) Following Cancer Treatment: Results From an Internet-Based Survivorship Care Plan (SCP) Tool
M. Frick1, C. Vachani2, M. K. Hampshire2, C. Bach2, K. Arnold-Korzeniowski2, J. M. Metz3, and C. E. Hill-Kayser1; 1Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, 2University of Pennsylvania, Philadelphia, PA, 3University of Pennsylvania, Department of Radiation Oncology, Philadelphia, PA

Purpose/Objective(s): Accurate monitoring of LLTEs following treatment for cancer is essential so that medical management may be optimized and quality of life maximized for these survivors. Very often, documentation of this information solely relies on its detection and interpretation by healthcare providers (HCPs). We hypothesize that HCPs under-report LLTEs compared to patient-reported outcomes (PROs).

Materials/Methods: Between October 2011 and December 2016, a publicly available Internet-based SCP tool adaptively queried users about LLTEs dependent on disease site and treatments received for generation of a customized SCP. Multivariate logistic regression was performed to explore the effect of patient- versus provider-reporting on incidence of LLTEs, controlling for survivor gender, race, age at diagnosis, current age, education, cancer care center, managing HCP, and distance from treatment center.

Results: 10,405 self-reporting survivors and 26,904 HCPs accessed the SCP tool and completed its respective queries on LLTEs. SCPs were completed for survivors of myriad cancer types, most commonly breast (51%), prostate (5%), lung (5%), colon (5%), head & neck (4%), Hodgkin's lymphoma (3%), ovarian (3%), endometrial (2%), and rectal (2%) cancer, among others. SCPs were completed for survivors of female gender (76%), Caucasian race (79%), mean diagnosis age of 54y, mean current age of 57y, and having received treatment at a non-university- or university-based cancer center (49% and 31%, respectively). Table 1 presents the effect of provider-reported versus PROs across a variety of LLTEs.

Conclusion: HCPs frequently under-report subjective symptoms experienced by cancer survivors, especially compared to reporting of classic, quantifiable medical conditions. This observation suggests that subjective symptoms may be overlooked in clinical visits unless survivors prompt the conversation and offers a complementary role of PROs when defining the survivorship experience. Integration of survivor-reported LLTEs into the electronic medical record should be a priority so that these perspectives are readily available in practice, with potential important implications for treatment decisions and follow-up care. Table 1. Effect of provider- versus patient-reporting on incidence of LLTEs
Late- and long-term effects Total n queried Patient- reported (% yes) Provider- reported (% yes) Adjusted OR (95% CI) p-value
Lung fibrosis/pneumonitis/obstructive/restrictive disease 4004 6% 3% 0.83 (0.66-1.03) 0.09
Heart failure 4137 2% 1% 0.99 (0.61-1.41) 0.94
Coronary artery disease 3897 3% 2% 0.78 (0.59-1.09) 0.14
Erectile dysfunction 1839 26% 11% 0.62 (0.51-0.75) <0.01
Female-related sexual dysfunction 6539 50% 18% 0.67 (0.62-0.72) <0.01
Cognitive changes 6601 59% 30% 0.64 (0.59-0.69) <0.01
Fatigue 8145 59% 41% 0.84 (0.79-0.90) <0.01
Changes in color or texture of skin at radiation portal 5603 47% 31% 0.93 (0.86-1.01) 0.09
Loss of flexibility in radiation portal 5603 32% 11% 0.74 (0.67-0.82) <0.01

Author Disclosure: M. Frick: None. C. Vachani: None. M.K. Hampshire: None. C. Bach: None. K. Arnold-Korzeniowski: None. J.M. Metz: None. C.E. Hill-Kayser: Employee; University of Pennsylvania.

Melissa Frick, MD

University of Pennsylvania

Disclosure:
No relationships to disclose.

Biography:
Dr. Melissa Frick is currently a PGY-1 resident physician, completing her transitional year internship at Crozer Chester Medical Center. She will be matriculating to the radiation oncology residency program at Stanford University in 2019. She is a recent graduate from the Perelman School of Medicine at the University of Pennsylvania.

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65 - Comparison of Provider - Versus Patient-Reported Late and Long-Term Effects (LLTEs) Following Cancer Treatment: Results From an Internet-Based Survivorship Care Plan (SCP) Tool



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