Feasibility and acceptability of the use of patient-reported outcome measures (PROMs) in the delivery of nurse-led supportive care to people with colorectal cancer

Eur J Oncol Nurs. 2017 Aug:29:115-124. doi: 10.1016/j.ejon.2017.06.002. Epub 2017 Jun 15.

Abstract

Purpose: Logistical issues pertinent to the use of patient-reported outcome measures (PROMs) by colorectal cancer nurse specialists (CNS) to identify the needs of people with colorectal cancer (CRC) in acute care remain unknown. We explored the feasibility and acceptability of PROMs-driven, CNS-led consultations to enhance delivery of supportive care to people with CRC completing adjuvant chemotherapy.

Methods: A systematic literature review and focus groups with patients and CNS (Phase 1) were followed by a repeated-measures, exploratory study (Phase 2), whereby pre-consultation PROM data were collected during three consecutive, monthly consultations, and used by the CNS to enable delivery of personalised supportive care.

Results: Based on Phase 1 data, the Supportive Care Needs Survey was selected for use in Phase 2. Fourteen patients were recruited (recruitment rate: 56%); thirteen (93%) completed all study assessments. Forty in-clinic patient-clinician consultations took place. At baseline, 219 unmet needs were reported in total, with a notable 21% (T2) and 32% (T3) over-time reduction. Physical/daily living and psychological domain scores declined from T1 to T3, yet not statistically significantly. In exit interviews, patients described how using the PROM helped them shortlist and prioritise their needs. CNS stressed how the PROM helped them tease out more issues with patients than they would normally.

Conclusions: Nurse-led, PROMs-driven needs assessments with patients with CRC appear to be feasible and acceptable in clinical practice, possibly associated with a sizeable reduction in the frequency of unmet needs, and smaller decreases in physical/daily living and psychosocial needs in the immediate post-chemotherapy period.

Keywords: Acceptability; Cancer nurse specialist; Colorectal cancer; Feasibility; Nurse led; Patient-reported outcome measures; Supportive care; Unmet needs.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / nursing*
  • Colorectal Neoplasms / psychology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment*
  • Nurse's Role*
  • Oncology Nursing / methods*
  • Patient Reported Outcome Measures*
  • Patient-Centered Care / methods
  • Referral and Consultation*
  • Self-Help Groups
  • Surveys and Questionnaires