Factors influencing adherence to electronic patient-reported outcomes in palliative cancer care

BackgroundIn light of the expanding utilization of electronic patient-reported outcomes (ePROs) in healthcare settings, their integration into the standard practice of palliative care remains uncertain. This investigation aimed to identify the determinants linked with adherence to ePRO utilization within a Cancer Network in Brazil.MethodsEligible patients had metastatic solid cancer with an expected survival of over 3 months. They were enrolled in monthly ePRO assessments using the Integrated Palliative Outcome Scale (IPOS). Patients failing to complete assessments received one reminder. We conducted multivariate regression analyses to examine the factors influencing adherence. Patient characteristics (age, gender, marital status, education level, and cancer type), along with initial responses on the IPOS, were included as predictors. Follow-up time within palliative care was controlled for in the analysis.ResultsA total of 494 patients were included, with a median age of 67 years (range: 22-94). Most were female (56.1%), married (58.9%), and had at least high school education (77.7%). Most were diagnosed with gastrointestinal (33.2%), breast (20.2%), and genitourinary (14.8%) cancers. Patients had a median follow-up time within palliative care of 10.5 months (range: 3-63 months). Notably, younger age (β=-0.3, SE=0.01, p=0.004), female gender (β=-0.7, SE=0.36, p=0.03) and higher education (β =0.1, SE = 0.06, p = 0.009) were associated with higher ePRO adherence. Interestingly, lower initial assessment score was linked with increased ePRO adherence (p=0.002). Patients experiencing loss of appetite (β=0.4, SE=0.18, p=0.01), having an anxious family member (β=0.3, SE=0.16, p=0.03), and expressing a desire for more information (β=0.2, SE=0.11, p=0.04) also demonstrated higher ePRO adherence.ConclusionsOur findings underscore the need for tailored approaches to promote patient engagement and improve adherence to ePRO assessments in palliative care settings. Further research exploring interventions targeted at addressing these factors could enhance the integration of ePRO into routine clinical practice, ultimately leading to better patient outcomes and quality of care.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.