Longitudinal comparison of ePRO satisfaction ratings in patients with cancer receiving systemic or radiotherapy.

backgroundePROs implementation for patients in active treatment for cancer requires that the app be nonburdensome and that it does not incumber clinical care team (CCT) workflows. Therefore, comparing longitudinal patient satisfaction of a single solution for those receiving radiation therapy (RT) and systemic therapies (ST; chemo-, immuno-, and hormonal) is critical to ensuring that maximal clinical benefit can be achieved with minimal impact to the provision of care. METHODOLOGY: Active treatment ePRO users with working active accounts > 30 days, who answered the question “How likely are you to recommend (software name) to another patient” using an 11-point scale twice or more (n = 7,202), were included. At a minimum all participants had access to three features: 1) symptom-reporting (administered at specific intervals or ad-hoc) via CTCAE-derived questionnaires or health-related quality of life questionnaires, 2) a diary to record any personal information, and 3) a secure communication feature for corresponding with the CCT. Additional data were passively collected by the app. All variables were analyzed descriptively and via a negative binomial mixed model (NB) with patient as a random effect and repeated measurements with an autoregressive covariance structure.

resultsPatients (mean age=61.7 years, SD=11.8) were from the US (n=4,941; sites=12), Canada (n=1,700; sites=4) and Europe (n=561; sites=4). Additionally, most were English speakers (n=6,794; 94.3%), used a smartphone (n=5,480; 76.1%), and received systemic therapy (n=6,468; 89.8%). The mean number of app satisfaction reports per patient was 3.1 (SD=1.6; range 2-13). The mean rating at Time 1 was 8.5 (SD=2.5), which is high, and it increased slightly over time. The NB mixed model found that satisfaction levels for patients receiving radiation did not significantly differ (p=0.835) from those receiving systemic therapy after adjusting for the other variables indicating that, over time, patients regardless of the treatment reported similar app satisfaction scores.

conclusionThese findings suggest that a single ePRO solution can be deployed with similarly high levels of patient satisfaction across two widely used treatment modalities, despite health system, practice, and ePRO deployment differences, minimizing CCT workflow and patient burden.