Patient-reported outcomes (PROs) programs for monitoring symptoms among patients treated with immunotherapy: A scoping review.

IF 3.4 Q2 ONCOLOGY JNCI Cancer Spectrum Pub Date : 2024-10-28 DOI:10.1093/jncics/pkae102
Sylvie D Lambert, Sara Soldera, Jordana Kazdan, Francesca Frati, Anita Slominska, Melina Boutin, Vanessa Samouelian, Caroline Letendre, Karine Bilodeau, Doris Howell, Karine Le Breton, Michel-Olivier Gratton
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Abstract

Background: Monitoring toxicities among patients receiving immune checkpoint inhibitors (ICIs) using patient-reported outcome (PRO) measures (PROMs) is relatively recent. This scoping review aims to guide decision-making in the development of PROMs ICI programs.

Methods: Four electronic databases were searched from inception to January 2024. Data on PROMs ICI programs (eg, PROMs used, frequency) were extracted. Two authors with established inter-rater reliability screened titles, abstracts, and full texts. A narrative synthesis identified patterns in the data.

Results: 22 articles described 16 unique multicomponent, electronic PRO programs, mainly developed for remote monitoring of toxicities between appointments. Patients typically completed 18-26 items from the PRO-CTCAE or CTCAE weekly, with high adherence/satisfaction. Commonly monitored symptoms were diarrhea, fatigue, shortness of breath, cough, nausea, decreased appetite, rash, joint pain, pain, and mood. Other features of PROM programs included clinician alerts, with some program only flagging symptoms that had an impact on treatment. Some program also or only sent alerts to patients to contact their clinicians and gave access to symptom management information. In terms of efficacy, the only consistent finding was an increase in QOL.

Discussion: The findings of this scoping review provide some indication as to which components of a PROM program are promising. However, as the evidence-based for PROMs among patients receiving ICIs is growing, many questions remain, including which symptoms to monitor, using which PROM, and at what frequency. More trials are needed to answer these questions and to determine how best to implement PROM ICI programs in clinical practice.

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用于监测接受免疫疗法患者症状的患者报告结果 (PROs) 计划:范围综述。
背景:使用患者报告结果(PRO)指标(PROMs)监测接受免疫检查点抑制剂(ICIs)治疗的患者的毒性相对较新。本综述旨在为制定PROMs ICI计划的决策提供指导:方法:检索了从开始到 2024 年 1 月的四个电子数据库。提取了有关 PROMs ICI 项目的数据(如使用的 PROMs、频率)。两位作者对标题、摘要和全文进行了筛选,他们的筛选结果具有良好的互评可靠性。结果:22 篇文章描述了 16 个独特的多组件电子 PRO 程序,主要用于在预约期间远程监测毒性。患者通常每周完成 18-26 个 PRO-CTCAE 或 CTCAE 项目,依从性/满意度较高。常见的监测症状包括腹泻、疲劳、气短、咳嗽、恶心、食欲下降、皮疹、关节痛、疼痛和情绪。PROM 项目的其他特点包括向临床医生发出警报,有些项目只标记对治疗有影响的症状。有些程序也会或仅会向患者发出与临床医生联系的提示,并提供症状管理信息。在疗效方面,唯一一致的发现是患者的 QOL 有所提高:讨论:本范围综述的研究结果为 PROM 计划的哪些组成部分具有前景提供了一些启示。然而,随着在接受 ICIs 治疗的患者中使用 PROM 的证据越来越多,许多问题依然存在,包括监测哪些症状、使用哪种 PROM 以及监测的频率。需要进行更多试验来回答这些问题,并确定如何在临床实践中最好地实施 PROM ICI 计划。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JNCI Cancer Spectrum
JNCI Cancer Spectrum Medicine-Oncology
CiteScore
7.70
自引率
0.00%
发文量
80
审稿时长
18 weeks
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