PRO-based initiation of clinical interventions
Case Example 1: PRO-based initiation of clinical interventions for Emily
Example 1: Emily Summer
Emily, introduced in Chapter 7, has locally advanced breast cancer and is receiving radiation and hormonal therapy. Three weeks into treatment, she attends a clinic appointment having completed the PROM in advance.
Emily completes PROMs (including the EORTC QLQ-C30) weekly before the consultation.
Her oncologist and the nursing team review the weekly PRO data, monitor trends, and identify current changes: increased fatigue and joint pain and reduced physical and emotional functioning after 3 weeks of radiotherapy and 6 weeks of hormone therapy (red bars).
More information on interpreting PRO data can be found in Chapter 7.
During the appointment, the team discusses Emily’s responses with her to develop a shared and more in-depth understanding, prioritises the key issues based on their impact on her daily life, and agrees on interventions that align with her preferences.
They agree on the following interventions:
- Medication adjustment: pain medication dose adjusted (joint pain).
- Supportive care: referral to physiotherapy (fatigue / physical functioning).
- Mental health support: referral to psycho-oncology (emotional support / coping).
Emily continues weekly PRO assessments, which enable her healthcare team to monitor intervention effectiveness. At follow-up visits, the team reviews both the PRO data and Emily’s feedback. After four weeks, she reports less fatigue and joint pain, and better emotional well-being. In response, the team continues the current interventions with minor adjustments as needed.