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e-PRO within a Comprehensive Companion Program to reduce emergency visits and inpatient admission in a Peruvian
Patricia Rioja1, Rossana Ruiz2, Jhajaira Araujo3
1Department of Oncology, Clinica Oncosalud-Auna, Lima, Peru. patricia.rioja@auna.org.
Purpose:
To describe the implementation process of an e-PRO system integrated into a comprehensive support program for gastrointestinal (GI) cancer patients as part of the quality care improvement management of our institution and to demonstrate its impact in terms of health resource utilization.
Methods:
The "Comprehensive Companion Program" (CCP) was designed as a remote web-based intervention to comprehensively address patients' needs. It consists of three core elements: (1) an e-PRO questionnaire platform, (2) a channel to submit inquiries, and (3) a repository of educative resources. To examine the impact of the program on two indicators of health resource utilization, emergency room visits (ERV) and non-planned inpatient admissions (NIA), we conducted a retrospective cohort study, including GI cancer patients. Incidence rate (IR), IR ratios (IRR), and 95% confidence intervals were calculated. Time to first ERV and NIA curves were compared using the Kaplan Meier method and log rank test.
Results:
A total of 199 were included; 97 enrolled into the CCP. The median age was 61 years (30-92 years), and 51.5% of patients were EGOG 0-1. Chemotherapy was the most common treatment (88.4%). The mean follow time was of 8.3 and 6.7 months, for patients in CCP and not, respectively. ERV rate was 1.90 per person-year for patients enrolled into the CCP (95% CI 1.58-2.26) vs 2.42 per person-year for patients not enrolled (95% CI 2.03-2.86) which means a 21% decrease in ERV (IRR 0.79 (95% CI 0.61-1.01; p = 0.05)). NIA rate was 0.74 per person-year for patients enrolled into the CCP (95% CI 0.55-0.98) vs 1.09 per person-year for patients not enrolled (95% CI 0.84-1.40) which translated into a 32% decrease in NIA (IRR 0.68 (95% CI 0.46-1.00; p = 0.04)). There were not differences in time to first event for any outcome.
Conclusions:
This real-world experience demonstrates the feasibility of implementing an e-PRO system integrated into a comprehensive support program and highlights its potential impact on reducing healthcare resource utilization.
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