背景:患者报告的结果被认为是评估肿瘤患者主观健康状况的金标准。近年来,患者报告结果的电子评估(ePRO)在临床试验和实践中越来越受欢迎。然而,关于老年癌症患者完成ePRO评估的能力有限.
目的:我们的目的是调查不同年龄范围的成年癌症患者在家中和在治疗机构中完成ePRO评估的情况,并确定与以电子方式完成问卷能力相关的因素。
方法:这项回顾性纵向单中心研究涉及参与住院康复的癌症幸存者。患者在在家康复之前(T1)和在设施康复之后(T2)完成ePRO评估。我们分析了能够在T1和T2完成ePRO评估的患者比例,需要帮助的患者比例,以及患者完成标准化问卷所需的时间。进行了多变量逻辑回归分析,以确定ePRO完成率和需要帮助的预测因素。
结果:在2017年至2022年之间,本研究共纳入5571例患者。患者的平均年龄为60.3(SD12.2)岁(范围18至93岁),其中1135例(20.3%)被归类为老年患者(>70岁)。虽然超过90%(5060/5571)的患者完成了ePRO评估,>70岁年龄组完成评估的患者较少(T1时924/1135,81.4%vsT2时963/1135,84.8%).大约19%(1056/5571)的患者报告需要在家中进行ePRO评估。相比之下,该机构为6.8%(304/4483)。70岁以上的患者对援助的需求明显高于年轻年龄组的患者。此外,观察到性别差异,老年女性报告的援助需求高于男性(71-80岁:女性需要援助215/482,44.6%vs男性96/350,27.4%;P<.001和>80岁:女性102/141,72.3%vs男性57/112,50.9%;P<.001)。平均而言,患者需要4.9分钟(SD3.20)来远程完成30项问卷(欧洲癌症研究和治疗组织的生活质量问卷),与年轻年龄组相比,老年组患者花费的时间明显更长.较低的年龄和较高的身体机能是ePRO完成率和多元回归分析中需要帮助的最明显的预测因素。
结论:这项研究的结果表明,ePRO评估对老年癌症患者是可行的,但是老年患者可能需要帮助(例如,从亲戚那里)完成基于家庭的评估。在这一人群中进行内部评估可能更可行。此外,至关重要的是要仔细考虑哪些资源是必要的和可用的,以支持患者使用ePRO设备。
Patient-reported outcomes are considered the gold standard for assessing subjective health status in oncology patients. Electronic assessment of patient-reported outcomes (ePRO) has become increasingly popular in recent years in both clinical trials and practice. However, there is limited evidence on how well older patients with cancer can complete ePRO assessments.
We aimed to investigate how well adult patients with cancer of different age ranges could complete ePRO assessments at home and in a treatment facility and to identify factors associated with the ability to complete questionnaires electronically.
This retrospective longitudinal single-center study involved survivors of cancer who participated in inpatient rehabilitation. Patients completed ePRO assessments before rehabilitation at home (T1) and after rehabilitation at the facility (T2). We analyzed the rate of patients who could complete the ePRO assessment at T1 and T2, the proportion of patients who required assistance, and the time it took patients to complete standardized questionnaires. Multivariate logistic regression analyses were conducted to identify predictors of ePRO completion rate and the need for assistance.
Between 2017 and 2022, a total of 5571 patients were included in this study. Patients had a mean age of 60.3 (SD 12.2) years (range 18 to 93 years), and 1135 (20.3%) of them were classified as geriatric patients (>70 years). While more than 90% (5060/5571) of all patients completed the ePRO assessment, fewer patients in the age group of >70 years (924/1135, 81.4% at T1 vs 963/1135, 84.8% at T2) completed the assessment. Approximately 19% (1056/5571) of patients reported a need for assistance with the ePRO assessment at home, compared to 6.8% (304/4483) at the institution. Patients older than 70 years had a significantly higher need for assistance than those in younger age groups. Moreover, a gender difference was observed, with older women reporting a higher need for assistance than men (71-80 years: women requiring assistance 215/482, 44.6% vs men 96/350, 27.4%; P<.001 and >80 years: women 102/141, 72.3% vs men 57/112, 50.9%; P<.001). On average, patients needed 4.9 (SD 3.20) minutes to remotely complete a 30-item questionnaire (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire) and patients in the older age groups took significantly longer compared to younger age groups. Lower age and higher physical functioning were the clearest predictors for both the ePRO completion rate and the need for assistance in the multivariate regression analysis.
This study\'s results indicate that ePRO assessment is feasible in older individuals with cancer, but older patients may require assistance (eg, from relatives) to complete home-based assessments. It may be more feasible to conduct assessments in-house in this population. Additionally, it is crucial to carefully consider which resources are necessary and available to support patients in using ePRO devices.