Benefits of PROMs for clinical practice
Identification and communication of therapeutic and supportive needs
Patients’ self-perceptions, e.g. of their symptom burden, can differ considerably from the assessment of healthcare professionals (HCPs).
- struggle to perceive or describe symptoms
- have physical communication barriers (e.g., speech problems in head/neck cancer)
- assume unasked issues are unimportant
- avoid seeming “complaining” or creating extra workload
- forget due to time pressure or information overload
- do not realise symptoms are clinically relevant
- answer what they think is expected from them
- suppress symptoms they interpret as disease worsening
- avoid sensitive topics (e.g., sexuality)
- rate symptoms as less severe than patients
- focus on common, severe, observable, or easily treatable symptoms (e.g., nausea/vomiting)
- prioritise medical issues over other concerns (e.g., social/financial problems)
- be less sensitive than patients to changes in severity
- avoid sensitive topics (e.g., sexuality)
- lack time for detailed symptom exploration
PROMs can improve problem identification by detecting cancer- or therapy-related burden more frequently and earlier, especially when the symptoms are not easily observable (e.g. fatigue, emotional burden) or the issues are sensitive (e.g. sexuality).
They can also improve HCP-patient communication by
- increasing the (self-) awareness and reflection of patients
- supporting patients to articulate their concerns
- raising awareness of HCPs to individual needs.
Studies1,2 show this leads to more frequent discussions of patient-relevant issues, including HRQOL domains beyond symptoms (e.g., work, social, or financial difficulties).
Adam, Burton, Bond, Bruin, & Murchie, 2016; Atkinson et al., 2015; Gilbert et al., 2015; Jacobsen, Moldrup, Christrup, & Sjogren, 2009; Xiao, Polomano, & Bruner, 2013
1 Graupner et al. 2021; 2 Kotronoulas et al. 2014