Facilitating comprehensive, person-centered, and evidence-based real time symptom management in cancer care across Quebec with mobile technology: The e-IMPAQc project
Abstract
Background/Purpose: Based on previous findings, we found that Patient-Reported Outcomes (PROs) completed by oncology patients electronically at point-of-care was acceptable and provided immediate, focused discussions with clinicians regarding symptom management. To date, no distress-screening program includes screening for Caregiver-Reported Outcomes (CROs). The aim of e-IMPAQc is to develop, implement and evaluate the effect on outcomes of the systematic assessment of PROs using mobile technology, and complete foundational work on the feasibility of the systematic assessment of CROs. The mobile application will integrate PROs data into the electronic health record and trigger stepped-care referral and clinical care pathways integrating evidence-based, self-management information tailored to the patients' and caregivers' experience.
Methods: Seven Quebec cancer centers are participating in this project, including two pediatric centers. Patient partners are integral members of the project team. Research and consultation for the development phase of the project were divided into working groups. Methods for the PRO/CRO and patient education working groups are presented here. The PRO/CRO working group held focus groups across centers with patients (n = 25), caregivers (n = 16), and providers (n = 42) and distributed surveys (n = 775) to clinicians and clinical managers implicated in oncology distress and symptom screening programs. Qualitative analysis identified emerging themes and provided real-world context that was considered alongside current literature to finalize the questionnaire module of the application. The patient education working group used the Suitability Assessment Measure and the DISCERN for an objective evaluation of existing, high-quality resources, and made evidence-informed decisions about their inclusion in the education module of the application.
Results: The physical and psychosocial symptoms identified as priority PROs and CROs from patient and professional perspectives will be presented. Results from the evaluation of the educational resources as well as additional considerations for selection will be presented.
Conclusions and Implications: This project brings together multidisciplinary healthcare professionals and patient partners to innovate the field of PROs by promoting an integrated approach to symptom management through timely assessment and the incorporation of selfmanagement materials into the clinical care pathway. The implementation of e-IMPAQc is in collaboration with the Quebec Ministry of Health and aligned with current distress and symptom screening and management guidelines.
Acknowledgement of Funding: Canadian Partnership Against Cancer; St. Mary’s Hospital Foundation.
John Kildea
Associate Professor (tenured) of Medical Physics
