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Adherence to daily electronic symptom screening in pediatric cancer: associations with time, location and pain
Jonas Dreher1, Andreas Meryk2, Johannes M Giesinger1
1University Hospital of Psychiatry II, Medical University of Innsbruck, Anichstraße 35, Innsbruck, AT-6020, Austria.
Insights
Daily symptom monitoring using patient-reported outcome measures (PROMs) is feasible for pediatric cancer patients. Adherence improved during inpatient stays and when pain was reported, suggesting potential for improved health outcomes.
Area of Science:
- Oncology
- Digital Health
- Patient-Reported Outcomes
Background:
- Regularly collected patient-reported outcome measures (PROMs) are crucial for early symptom detection and improved health outcomes in pediatric cancer care.
- Investigating adherence to daily PROMs and associated factors is essential for optimizing their use in this population.
Purpose of the Study:
- To explore patient-reported outcome measure (PROM) adherence among pediatric cancer patients undergoing chemotherapy.
- To identify factors associated with daily PROM completion within the first year of treatment.
Main Methods:
- Prospective analysis of daily PROM data collected via a web-based portal (ePROtect) from pediatric cancer patients.
- Descriptive analysis and linear mixed-effects modeling were used to evaluate PROM adherence and associated factors.
Main Results:
- Mean PROM adherence was 48.7%, with highest adherence (77.1%) in the first 30 days.
- Lower adherence was associated with longer time in the program and intensive care unit admission.
- Higher adherence was linked to inpatient stays and self-reported pain; adverse events showed no significant association.
Conclusions:
- Daily symptom monitoring via PROMs is feasible for pediatric cancer patients over extended periods.
- PROM adherence stabilizes over time, with increased participation during inpatient stays and self-reported pain.
- Strategies to further enhance PROM adherence in pediatric oncology require further investigation.
Purpose:
Regularly collected patient-reported outcome measures (PROMs) can facilitate early symptom detection and improve health outcomes. This explorative analysis aimed to investigate PROM adherence and factors associated with daily PROM completion among pediatric cancer patients.
Methods:
We analyzed data from a prospective study at the Medical University of Innsbruck in which pediatric patients with cancer treated with chemotherapy completed daily PROMs via a web-based portal (ePROtect). We analyzed the PROM adherence during their first year of treatment descriptively and using a linear mixed model to evaluate factors associated with PROM adherence.
Results:
Fifty patients (42% female) with a median age of 10.7 years (IQR 7.1-15.4) were included in this analysis (analysis period 05/2020 to 05/2023). The mean adherence was 48.7% (SD 27.2), with the highest adherence during the first 30 days (77.1%). Significant predictive factors for lower adherence included time in the program (logarithmic; β = -0.093, p < 0.001) and admission to the intensive care unit (β = -0.224, p < 0.001). In contrast, inpatient stays (β = 0.035, p = 0.014) and self-reported pain (β = 0.087, p = 0.002) were significant predictors for higher PROM adherence. Occurrences of adverse events were not significantly associated with adherence.
Discussion:
Our findings suggest that continuous daily symptom monitoring is feasible over extended periods. PROM adherence stabilized over time despite an initial drop, with higher participation observed during inpatient stays and in weeks with self-reported pain. Future research should explore and evaluate strategies to improve adherence.
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