Patient Reported Outcomes and Unscheduled Health Services use During Oral Anti-Cancer Treatment

Area of Science:

• Oncology
• Health Services Research
• Patient-Reported Outcomes

Background:

• Patients on oral anti-cancer agents require self-management of symptoms with limited provider interaction.
• Symptoms and physical function are critical patient-reported outcomes (PROs) that can influence healthcare utilization.
• Unscheduled healthcare use, including urgent care, emergency department (ED) visits, and hospitalizations, increases healthcare costs.

Purpose of the Study:

• To assess if age, sex, and comorbidity predict unscheduled healthcare use in patients on oral anti-cancer agents.
• To determine the extent to which PRO data (symptoms and functioning) enhance the prediction of unscheduled healthcare use.

Main Methods:

• A post-hoc analysis of 117 patients from the control group of an intervention trial for oral anti-cancer agents.
• PROs, including 18 symptom severities, physical function, and depressive symptoms, were assessed at baseline and at 4, 8, and 12 weeks.
• Generalized mixed effects models analyzed unscheduled healthcare use in relation to demographic factors and PROs.

Main Results:

• The summed severity of 18 symptoms and physical function significantly predicted hospitalizations within four weeks of PRO assessment.
• Incorporating PROs improved the predictive accuracy (area under the receiver operating characteristic curves > 0.70) in most time periods.

Conclusions:

• Monitoring patient-reported outcomes (PROs) shows potential for reducing unscheduled healthcare utilization.
• Implementing supportive care interventions based on PRO levels could mitigate unplanned healthcare visits and hospitalizations.