PRO-CTCAE Tool Improves Symptom Management in Head and Neck Oncology Clinic

A quality improvement initiative at the James Cancer Hospital and Solove Research Institute demonstrated that integrating the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) tool into clinical practice can significantly enhance symptom monitoring and patient care in a head and neck oncology clinic.

The study, published in Journal of the Advanced Practitioner in Oncology, implemented the PRO-CTCAE tool to address gaps in symptom assessment and improve communication between patients and advanced practitioners. The authors noted that "head and neck cancer patients often experience significant symptom burden due to both disease and treatment," making early symptom identification and intervention essential.

During the three-month pilot period, 70% of eligible patients completed the PRO-CTCAE survey prior to their clinical visits. This digital tool enabled patients to report 11 treatment-related symptoms, including pain, fatigue, nausea, and difficulty swallowing, using a secure online platform integrated with the electronic health record (EHR). The responses were reviewed by clinicians prior to patient encounters, facilitating timely discussions and interventions.

A key outcome of the study was improved symptom documentation. "There was a 35% increase in documentation of symptom management interventions during the pilot phase compared to baseline," the authors reported. The tool also helped standardize symptom assessment, reducing reliance on subjective verbal reports.

Importantly, clinician feedback was positive. Advanced practitioners in the clinic noted that the PRO-CTCAE responses helped prioritize patient concerns and guide supportive care strategies. Additionally, the tool identified previously underreported symptoms, such as anxiety and insomnia, which may have otherwise been missed in routine clinical encounters.

The study highlights the operational feasibility of incorporating PRO-CTCAE into routine workflows. Minimal disruption to clinic efficiency was observed, and the majority of patients reported ease of use and satisfaction with the system. As the authors stated, “Use of the PRO-CTCAE tool supported more structured symptom conversations and provided objective data to support care decisions.”

For practicing oncologists and advanced practitioners, these findings underscore the value of integrating patient-reported outcomes into routine care. By enabling early identification of symptoms and streamlining documentation, the PRO-CTCAE tool may contribute to more effective symptom management, improved patient satisfaction, and potentially better clinical outcomes.

The success of this pilot has prompted plans for broader implementation across oncology clinics within the institution, with continued evaluation of its impact on patient care quality and provider workflows.

Source:

Hearn H, Fahey K, Primm K, et al. Improving Practice in a Head and Neck Oncology Clinic Using the PRO-CTCAE Tool. J Adv Pract Oncol. 2024;15(2):184-190.