Randomized controlled trials at academic medical centers have shown that clinical outcomes improve when utilizing patient-reported outcome (PRO)-based symptom management solutions, according to Sandra L. Wong, MD, MS (Dartmouth-Hitchcock Medical Center, Lebanon, NH), and colleagues, who presented “Severe symptom reporting in surgical patients assessed through an EHR-integrated ePRO questionnaire at 6 cancer centers” at the 2022 ASCO Quality Care Symposium. This strategy can benefit patients undergoing surgery for suspected malignancies, as they risk experiencing serious postoperative symptoms that can compromise outcomes and necessitate acute care.

Attempts to generalize this strategy has been challenged by the viewpoint that severe symptoms are rare and responding to them can be difficult, Wong explained. There remains uncertainty as to which symptoms are likely to be severe.

Six US-based health care systems used the electronic health record (EHR)-integrated system management program eSyM. Patients who were undergoing surgery for suspected or confirmed thoracic, gastrointestinal (GI), and gynecologic malignancies were provided automated questionnaires through MyChart 1 to 3 times a week for up to 3 months after discharge from the hospital. Based on the Patient-Reported Outcomes-Common Terminology Criteria for Adverse Events questionnaire, eSyM consists of 30 symptoms (10 required and 20 optional) with scores ranging from 0 (no symptoms) to 3 (severe), as well as additional questions to evaluate functional status, overall wellbeing, wound discharge, and wound redness.

Between October 2019 and March 2022, a total of 21,012 eSyM questionnaires were submitted by 3,781 unique patients. In 17% of the questionnaires, patients reported at least one severe symptom, with physical function impairment (12.5%), general pain (10.5%), and fatigue (6.6%) as the three most reported symptoms. According to researchers, younger, female, or unemployed patients (P < .01) tended to be more likely to report severe symptoms.

Wong and colleagues concluded that symptom monitoring using a system like eSyM could provide a benefit to patients without being too time-consuming or difficult for physicians. There were few predictors of severe symptoms, suggesting that population surveillance might be a better-suited strategy than targeted surveillance.

Source

Wong S, Hazard-Jenkins H, Schrag D, et al. Severe symptom reporting in surgical patients assessed through an EHR-integrated ePRO questionnaire at 6 cancer centers. Presented at: the 2022 ASCO Quality Care Symposium; September 30- October 1, 2022; Chicago, IL, and virtual; Abstract 243.