PROMS Tool Revealed Unmet Needs in Care of Resected Colorectal Cancer

Use of a patient-reported outcome measures (PROMS) tool revealed a number of unmet needs of patients who underwent surgical treatment for colorectal cancer. The tool, developed by a multidisciplinary team, was described in a report published in Colorectal Disease.

Although the benefits of incorporating PROMS into the care of patients with colorectal cancer has been previously recognized, the format of a PROMS tool that best meets the needs of patients with colorectal cancer treated with surgery has not yet been established.

A multidisciplinary research team of surgeons, physicians, nurse specialists, psychologists, sociologists, and patient representatives developed a PROMS tool consisting of a questionnaire incorporating the EQ5D-3L (an assessment of mobility, self-care, usual activities, pain/discomfort, and anxiety/depression), the distress thermometer, a validated measure of stigma, FACT-C, the 34-item supportive care needs survey, and a newer scale incorporating the Psychological Impact of Cancer.

Over a 2-month period, pilot groups of patients completed the PROMS tool, as well as an accompanying questionnaire capturing basic patient details and patient evaluation of the tool. Participating patients were then subsequently invited to attend semistructured focus groups to further explore the physical and psychological impacts of colorectal cancer surgery, as well as related treatments, and to further evaluate the PROMS tool.

Between 26 and 29 patients completed individual components of the PROMS tool, and the accompanying questionnaire was completed by 35 patients; all participants were within 3 years of their cancer diagnosis. An evaluation of responses revealed that patients reported unmet needs in the physical domain (38.5%), the psychological domain (46.2%), the sexuality domain (15.4%), the patient care domain (7.7%), and the health systems and information domain (23.1%.  

The general consensus of patients participating in a 1-hour focus group (n=29) was that the PROMS tool was too long and too difficult to complete. The most common thematic areas identified during the focus groups were physical symptoms, emotional response, information provision, and coping mechanisms.

The tools and data from this study can be used by healthcare providers to explore how they can better meet the holistic needs of their patients, the researchers stated.

Reference

Sutton PA, Bourdon-Pierre R, Smith C, et al. Evaluating unmet needs in patients undergoing surgery for colorectal cancer: a patient reported outcome measures (PROMS) study [published online March 3, 2019]. Colorectal Dis. doi: 10.1111/codi.14599