From reporting to relating: Reimagining ePROMs in cancer symptom management.

Area of Science:

• Digital Health
• Oncology
• Patient-Reported Outcomes

Background:

• Electronic Patient-Reported Outcome Measures (ePROMs) are increasingly used in cancer care to monitor symptoms like pain, anxiety, and fatigue.
• While ePROMs aid symptom recognition, their impact on patient-provider connection and mutual understanding is underexplored.

Purpose of the Study:

• To investigate how integrating digital symptom reporting via ePROMs influences symptom reporting content and patient-provider relational dynamics.
• To explore cancer patients' experiences and perceptions of ePROM technology in symptom management.

Main Methods:

• Conducted 46 in-depth interviews with advanced cancer patients in the E2C2 trial at Mayo Clinic.
• Employed deductive frame analysis and inductive analysis, informed by Boundary Object Theory.

Main Results:

• Patient engagement with ePROMs was shaped by personal symptom perception, coping styles, and prior care team interactions.
• ePROMs facilitated symptom articulation but raised patient concerns about review and interpretation by clinicians.
• Patients perceived ePROMs as indicators of which symptoms providers valued, subtly altering their illness understanding and self-management roles.

Conclusions:

• ePROMs function as relational artifacts, influencing both information coordination and interpersonal dynamics between patients and providers.
• Designing ePROMs requires attention to their interpretive and emotional effects to foster connection and shared understanding alongside data collection.