A Short Patient-Reported Outcome Measure for Oral Anticancer Agents: Multicenter Observational Study

The Michigan Oncology Quality Consortium developed a rapid patient-reported outcome measure (RapidPRO) focused on oral anticancer agents (OAAs). We piloted this measure in 6 oncology practices to determine its usefulness in representing the symptom experience and medication adherence among individuals taking OAAs. It is common in oncology for cancer-specific approaches to be used. We sought to use 1 instrument for all OAAs as a means to simplify future implementation in practice.

This study aimed to describe the use of RapidPRO in practice and quantify clinical metrics in RapidPRO for symptom burden, confidence to manage symptoms, confidence to know when to seek care, and OAA medication adherence.

This observational study was conducted across 6 practices from July 2016 to December 2018. RapidPRO assesses symptoms, patient confidence, and medication adherence with respect to OAAs.

There were 2252 RapidPROs completed by 695 patients. Among individuals completing at least 2 RapidPROs, the median number of days between them was 28 (IQR 14-42). Of the 2252 completed RapidPROs, 1213 (53.9%) reported at least one moderate or severe symptom, and 28% (485/1705) reported medication nonadherence. Most bothersome symptoms (MBSs; n=1045) were reported in 35.1% (790/2252) of the RapidPROs, and 46.5% (323/695) of all patients reported an MBS. In exploratory analyses, RapidPROs that reported a moderate or severe symptom or lower confidence to manage symptoms were more likely to be nonadherent to OAA therapy. The most common reason for medication nonadherence was "experienced side effects."

These results show that most RapidPROs reported at least one moderate or severe symptom and 28% (485/1705) reported medication nonadherence. As well, RapidPRO was able to capture most patients' MBSs. By implementing RapidPRO, practices can identify patients who experience symptoms, as well as those who report medication nonadherence.