Nurse-Collected PRO Initiative May Increase Improve QoL in Older Patients Receiving Treatment

The use of patient-reported outcomes (PROs) in clinical practice significantly improved quality of life (QoL) among older patients receiving active anticancer treatment, according to a study presented during the 2021 ASCO Annual Meeting.

PROs are outcomes directly reported by the patient without interpretation from a clinician as it relates to a patient’s overall health and quality of life. Clinical measures may assess such outcomes as mortality, survival, and physiological outcomes pertaining to disease treatment; however, PROs provide a more personal and natural interpretation of any benefits or adverse events associated with therapy.

For example, the findings of a new drug trial will report clinical effects, such as length of treatment and progression-free survival, while PROs give a more holistic picture, and may discern any non-compliance to treatments, or complexity of drug regimens.

In this study, patients receiving active anticancer treatment as outpatients were included. Patients treated in 2017 received “usual” visits (group A). In 2018, patients started filling out a paper questionnaire from a dedicated nurse to collect data on symptoms and toxicities, which were then discussed during the visit (group B).

Final analysis included 211 patients, including 88 who were aged >70 years (group A, n=47; group B, n=41). The median age was 76 years, and the most common tumors were colorectal (25%), lung (22.7%), and pancreatic (17%); more than two-thirds of patients were receiving first-line treatment.

After one month, older patients in group B had much better global QoL than group A: mean change from baseline in group A was -0.89, compared to +4.47 in group B. Mean changes in role functioning and emotional functioning were statistically significant and favored group B. Group B also had much better mean changes from baseline for pain.

“This secondary analysis shows that the use of PROs in clinical practice, thanks to an active role of nurses and discussion of symptoms with physicians during the visit, is associated, also in older patients receiving active anticancer treatment, with a significant improvement in global QoL,” the researchers concluded.

Nurses and other members of the oncology care team should consider implementing PROs into their practice setting, especially when it comes to treating elderly patients.