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Feasibility and delivery of patient-reported outcomes in clinical practice among racially diverse bladder and prostate cancer patients
Authors:Angela B. Smith  Cleo A. Samuel  Sean D. McCabe  Allison Deal  Mattias Jonsson  Dana E. Mueller  Zahra M. Mahbooba  Antonia V. Bennett  Arlene E. Chung  Matthew E. Nielsen  Hung-Jui Tan  Eric Wallen  Raj Pruthi  Andrew Wang  Ethan Basch  Bryce B. Reeve  Ronald C. Chen
Affiliation:1. University of North Carolina, Department of Urology, Chapel Hill, NC;2. University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel Hill, NC;3. University of North Carolina, Department of Health Policy and Management, Chapel Hill, NC;4. University of North Carolina, Lineberger Comprehensive Cancer Center, Biostatistics Core, Chapel Hill, NC;5. University of North Carolina, Department of Biostatistics, Chapel Hill, NC;6. University of North Carolina at Chapel Hill School of Medicine, Departments of Medicine and Pediatrics, Chapel Hill, NC;7. University of North Carolina, Department of Health Policy and Management, Chapel Hill, NC;8. Kaiser Permanente Center for Health Research, Portland, OR;9. University of California- San Francisco, San Francisco, CA;10. University of North Carolina at Chapel Hill School of Medicine, Department of Medicine, Division of Hematology/Oncology, Chapel Hill, NC;11. Duke University School of Medicine, Department of Population Health Sciences, Durham, NC;12. University of Kansas, Department of Radiation Oncology, Kansas City, KS
Abstract:ObjectiveTo assess the feasibility of enrollment and collecting patient-reported outcome (PRO) data as part of routine clinical urologic care for bladder and prostate cancer patients and examine overall patterns and racial variations in PRO use and symptom reports over time.Subjects/Patients and MethodsWe recruited 76 patients (n = 29 Black and n = 47 White) with prostate or bladder cancer at a single, comprehensive cancer center. The majority of prostate cancer patients had intermediate risk (57%) disease and underwent either radiation or prostatectomy. Over half (58%) of bladder cancer patients had muscle invasive disease and underwent cystectomy.Patients were asked to complete PRO symptom surveys using their preferred mode [web- or phone-based interactive voice response (IVR)]. Symptom summary reports were shared with providers during visits. Surveys were completed at 3 time points and assessed urinary, sexual, gastrointestinal, anxiety/depression, and sleep symptoms. Feasibility of enrollment and survey completion were calculated, and linear mixed effects models estimated differences in outcomes by race and time.ResultsSixty three percent of study participants completed all PRO measures at all 3 time points. Black patients were more likely to select IVR as their survey mode (40% vs. 13%, P < 0.05), and less likely to complete all surveys (55% vs. 74%, P = 0.13). Patients using IVR were also less likely to complete all surveys (41% vs. 69%, P = 0.046).ConclusionsReported preferences for survey mode and completion rates differ by race, which may influence survey completion rates and highlight potential obstacles for equitable implementation of PROs into clinical care.
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