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Utilizing the Patient Reported Outcomes Measurement Information System (PROMIS®) to increase referral to ancillary support services for severely symptomatic patients with gynecologic cancer

  • Gregory M. Gressel
    Correspondence
    Corresponding author at: Montefiore Medical Center, Albert Einstein College of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1300 Morris Park Avenue, Belfer 501, Bronx, NY 10461, United States of America.
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America

    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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  • Shayan M. Dioun
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America
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  • Michael Richley
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America
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  • David W. Lounsbury
    Affiliations
    Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
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  • Bruce D. Rapkin
    Affiliations
    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America

    Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
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  • Sara Isani
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America

    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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  • Nicole S. Nevadunsky
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America

    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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  • D.Y.S. Kuo
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America

    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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  • Akiva P. Novetsky
    Affiliations
    Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America

    Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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      Highlights

      • PROMIS ePRO assessments can identify severe cancer symptoms in gynecologic oncology.
      • Patients find PROMIS ePROs easy to complete and helpful in addressing symptoms.
      • PROMIS identification of severe symptoms increases referral to supportive services.
      • Longitudinal studies must assess if ePRO scores improve with referral utilization.

      Abstract

      Objective

      The Patient-Reported Outcomes Measurement Information System (PROMIS®) Network has developed a comprehensive repository of electronic patient reported outcomes measures (ePROs) of major symptom domains that have been validated in cancer patients. Their use for patients with gynecologic cancer has been understudied. Our objective was to establish feasibility and acceptability of PROMIS ePRO integration in a gynecologic oncology outpatient clinic and assess if it can help identify severely symptomatic patients and increase referral to supportive services.

      Methods

      English-speaking patients with a confirmed history of gynecologic cancer completed PROMIS ePROs on iPads in the waiting area of an outpatient gynecologic oncology clinic. Symptom scores were calculated for each respondent and grouped using documented severity thresholds. Response data was compared with clinicopathologic characteristics across symptom domains. Severely symptomatic patients were offered referral to ancillary services and asked to complete post-exposure surveys assessing acceptability of the ePRO.

      Results

      Of the 336 patients who completed ePROs, 35% had active disease and 19% had experienced at least one disease recurrence. Sixty-nine percent of the cohort demonstrated moderate to severe physical dysfunction (60%), pain (36%), fatigue (28%), anxiety (9%), depression (8%), and sexual dysfunction (32%). Thirty-nine (12%) severely symptomatic patients were referred to services such as psychiatry, palliative care, pain management, social work or integrative oncology care. Most survey respondents identified the ePROs as helpful (78%) and easy to complete (92%).

      Conclusions

      Outpatient PROMIS ePRO administration is feasible and acceptable to gynecologic oncology patients and can help identify severely symptomatic patients for referral to ancillary support services.

      Keywords

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