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Real-World Impact of Electronic Patient-Reported Outcomes on Early Intervention Among Older Patients With Lung
Yasuhiro Nakajima1,2, Tetsushi Maesako1,2, Takashi Murata1,2
1Department of Respiratory Medicine, Himeji St. Mary's Hospital, 650 Nibuno, Himeji, Hyogo, 6700801, Japan, 81 792655111, 81 792655001.
Background:
Electronic patient-reported outcomes (ePROs) have demonstrated greater sensitivity in detecting adverse events than clinician-reported outcomes. However, conventional care faces challenges related to recall bias, and evidence from real-world populations of older adults is limited. This study evaluates the feasibility of an ePRO system integrated with ecological momentary assessment and ecological momentary intervention (EMI) to facilitate a concordance model within the framework of digital transformation in health care.
Objective:
This study aimed to evaluate the satisfaction, usability, and clinical impact of an ePRO system integrated with ecological momentary assessment and EMI in a real-world cohort of older patients with lung cancer and to investigate its ability to facilitate a patient-centered concordance model within the framework of digital transformation in health care.
Methods:
In this single-center prospective cohort study, 35 patients with lung cancer used the Welby My Carte ONC app to record daily symptoms and visual data. Satisfaction and usability were evaluated using 10-point scales at the end of the first and third treatment cycles. The study focused on the clinical impact of EMI triggered by ePRO data, such as early detection of toxicity.
Results:
The cohort included a high proportion of older patients (20/35, 57%) aged 70 to 89 years. Satisfaction and usability scores significantly improved over time (satisfaction: 6.0 to 8.0, P<.001; usability: 5.0 to 8.0, P<.001). ePRO monitoring enabled the early detection of critical events, including immune-related uveitis (case 1), Stevens-Johnson syndrome (case 2), rare drug-induced purpura (case 3), and the monitoring of infusion-related reactions (case 4).
Conclusions:
ePRO monitoring is feasible for older patients with lung cancer and enhances safety through timely EMI. It serves as a core component of a comprehensive patient support program and supports the transition to a more active concordance model, ultimately improving patient well-being.