Patient Reported Outcomes Used in Radiation Programs Across Canada


Purpose: The Canadian Partnership for Quality Radiotherapy (CPQR) supports the use of patient reported outcomes (PRO) as an essential component of quality patient care and is committed to developing processes that promote the use of PRO. The overall aim is promote PRO as both a point-of-care tool and a cancer system performance tool in population-based learning.

Objectives: To conduct a pan-Canadian environmental scan to determine what PROs are in place; how they are being used; barriers and facilitators to their use and implementation, as well as the potential utility of guidance from CPQR regarding PRO use in the radiotherapy (RT) setting.

Materials and Methods: A multidisciplinary PRO Working Group within the CPQR was assembled to provide guidance on the collection and use of (RT) specific PRO measures in radiation oncology programs (ROPs) across Canada both to support local uptake and facilitate pan-Canadian learning and knowledge mobilization. An interview framework was developed by the working group to determine what PRO tools are in use, barriers and facilitators to PRO use and implementation, and to elicit if centres have an interest in guidance from CPQR on PRO. Semi-structured telephone interviews were held (July to October 2018) with select members of Radiation Oncology Programs across Canada. Participants were identified by members of the CPQR National Quality Advisory Committee as the most knowledgeable individual(s) with regards to the use of PROs within their centre, particularly in the RT setting. Purposeful sampling was done to ensure representation by pan-Canadian geographic region, centre size and academic status. Interviews were held by telephone, audio-recorded and coded for common themes.

Results: Interviews were held with individuals from 20 centres across Canada at which time we determined saturation had been reached. Participating centres represented Ontario, Quebec, Atlantic Provinces, Alberta, Manitoba and British Columbia. Use of PROs varies considerably across the country from no current PRO use to PRO use being standard of care for every patient and multiple PROs in place. A total of 13 different PRO instruments were identified and their use within the centre described. A multitude of facilitators and barriers (e.g. lack of resources, patient/physician buy-in, patient burden, IT infrastructure) were reported. All centres expressed a strong desire to learn from other Canadian centres and endorsed guidance from CPQR on the use of PROs in the radiotherapy setting.

Conclusions: The use of PROs varies across Canadian Radiation Oncology Programs. The CPQR will continue to take a pan-Canadian approach to support consistent use and expansion of PRO use. Development of a CPQR Guidance Document on Patient Reported Outcomes is underway to inform PRO use and implementation of PROs into clinical care programs across Canada.

In Radiotherapy and Oncology
John Kildea
John Kildea
Assistant Professor of Medical Physics