Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

The impact of remotely completed real-time Patient Reported Outcome Measures (PROMs) on Emergency Department presentations (#129)

Kate Webber 1 2 , Alastair Kwok 1 2 , Olivia Cook 3 , Michelle White 2 , Eva Segelov 1 2
  1. School of Clinical Sciences, Monash University, Clayton, Vic, Australia
  2. Monash Health, Clayton, VIC, Australia
  3. Nursing and Midwifery, Monash University, Clayton, Vic, Australia

Aims:

To assess the impact of real-time Patient Reported Outcome Measures (PROMs) prior to telehealth consultations on subsequent Emergency Department (ED) presentations, and seek PROM data predictive of subsequent unplanned presentations.  

Methods:

Patients attending oncology telehealth appointments were invited to complete the EQ-5D-5L, modified Edmonton Symptom Assessment System-Revised (ESAS-R) and the Supportive Care Needs Survey Short-Form (SCNS-SF34) online from home prior to scheduled appointments over a 6-month study period. Clinical and demographic characteristics and data regarding ED presentations during the intervention period were extracted from medical records for both participants and non-participants. Descriptive statistics were prepared, chi-squared and t-tests were used for between groups comparisons.

Results:

Data were extracted from records of 111 patients representing 375 clinic consultations. Patients had a mean age of 59.8 (SD 15.3), 81% were female. Fifty (45%) opted to participate in the real-time PROMs intervention. No significant differences were noted between participants and non-participants in age, gender, cancer type, intent of treatment (curative vs palliative) or treatment received. There were 55 emergency department presentations by 28 patients over the intervention period. Fewer ED presentations were recorded among patients participating in the real-time PROMs intervention than non-participants (18 vs 37 ED presentations, p=0.094). Among PROMs participants, ED presentations were associated with higher mean symptom scores for pain (5.5 vs 2.9, p=0.010), fatigue (6.8 vs 4.5, p=0.014), and sleep disturbance (5.7 vs 3.4, p=0.026) at the preceding clinic visit within 30 days prior. EQ-5D and SCNS supportive care needs domain scores were not associated with a subsequent ED presentation.

Conclusions:

Remote completion of real-time PROMs prior to telehealth oncology consultations was associated with a trend to fewer emergency department presentations. Routine collection of PROMs allows identification of key symptoms of concern which may precede ED presentations and thus facilitate targeted interventions in this cohort.