Perceived barriers toward patient-reported outcome implementation in cancer care: An international scoping survey
Document Type
Journal Article
Publication Title
JCO Oncology Practice
Volume
20
Issue
6
First Page
816
Last Page
826
PubMed ID
38457755
Publisher
American Society of Clinical Oncology
School
School of Nursing and Midwifery
RAS ID
71511
Funders
Australian National Health and Medical Research Council
Grant Number
NHMRC Number : APP1194051
Abstract
PURPOSE: Implementation of patient-reported outcomes (PROs) collection is an important priority in cancer care. We examined perceived barriers toward implementing PRO collection between centers with and without PRO infrastructure and administrators and nonadministrators. PATIENTS AND METHODS: We performed a multinational survey of oncology practitioners on their perceived barriers to PRO implementations. Multivariable regression models evaluated for differences in perceived barriers to PRO implementation between groups, adjusted for demographic and institutional variables. RESULTS: Among 358 oncology practitioners representing six geographic regions, 31% worked at centers that did not have PRO infrastructure and 26% self-reported as administrators. Administrators were more likely to perceive concerns with liability issues (aOR, 2.00 [95% CI, 1.12 to 3.57]; P = .02) while having nonsignificant trend toward less likely perceiving concerns with disruption of workflow (aOR, 0.58 [95% CI, 0.32 to 1.03]; P = .06) and nonadherence of PRO reporting (aOR, 0.53 [95% CI, 0.26 to 1.08]; P = .08) as barriers. Respondents from centers without PRO infrastructure were more likely to perceive that not having access to a local PRO expert (aOR, 6.59 [95% CI, 3.81 to 11.42]; P < .001), being unsure how to apply PROs in clinical decisions (aOR, 4.20 [95% CI, 2.32 to 7.63]; P < .001), and being unsure about selecting PRO measures (aOR, 3.36 [95% CI, 2.00 to 5.66]; P < .001) as barriers. Heat map analyses identified the largest differences between participants from centers with and without PRO infrastructure in agreed-upon barriers were (1) not having a local PRO expert, (2) being unsure about selecting PRO measures, and (3) not recognizing the role of PROs at the institutional level. CONCLUSION: Perceived barriers toward PRO implementation differ between administrators and nonadministrators and practitioners at centers with and without PRO infrastructure. PRO implementation teams should consider as part of a comprehensive strategy including frontline clinicians and administrators and members with PRO experience within teams.
DOI
10.1200/OP.23.00715
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Comments
Eng, L., Chan, R. J., Chan, A., Charalambous, A., Darling, H. S., Grech, L., ... & Cheung, Y. T. (2024). Perceived barriers toward patient-reported outcome implementation in cancer care: An international scoping survey. JCO Oncology Practice, 20 (6), 816-826 . https://doi.org/10.1200/OP.23.00715