The Clinical Utility of Real-Time Patient-Reported Outcomes in Cell Therapy Recipients

The use of patient-reported outcome measures (PROMs) can improve a patient's clinical course by decreasing the incidence and severity of both physical and emotional treatment-related toxicities, uncover unmet patient needs, and assist in patients' shared decision-making. The objective of this study was to examine the feasibility and utility of using electronically captured "real time" agenda-setting questions and PROMs at the time of the patient's clinic visit. We designed a prospective observational study that employed a previsit questionnaire (PVQ) that included agenda-setting questions and the Patient-Reported Outcomes Measurement Information System 29-item profile survey, with results incorporated into a clinical decision support dashboard embedded within the patients' electronic medical record. The real-time results within the dashboard were used during each patient's clinic visit to encourage and support conversations between patients and their transplant clinician. Two hundred and thirty-seven consecutive cellular therapy recipients (allogeneic stem cell transplant, n = 98; autologous transplant, n = 106; or chimeric antigen receptor T cell, n = 33) seen between April 2022 and January 2025 were included. Over the study period, PVQ completion rates reached 80%, with an average of 60% weekly. The majority of patients (82%; n = 162) reported that the information in the dashboard helped them talk to their clinician about what mattered most, and 78% of patients (n = 154) noted that the dashboard helped them make healthcare decisions. Each of the transplant clinicians (n = 9) believed that the information gathered from the PVQ was helpful by aiding their discussions with the patient during the clinic visit. When using an internationally recognized and verified process to assess shared decision-making (CollaboRATE), 91% of patients (n = 180) believed that the dashboard assisted them in making future medical decisions. Eighty-nine percent of transplant clinicians agreed that the use of the PVQ aided patients in shared decision-making. Our results demonstrate the feasibility and utility of real-time PROMs and agenda-setting questions embedded within an electronic dashboard for cellular therapy patients. Both clinicians and patients noted marked benefits over the course of the study. These results support the ongoing need for capturing real-time PROMs with advantages to patients and their treating clinicians.