Pharmacist-facilitated Patient Reported Outcome Measure (PROM) monitoring: developing an EHR SmartForm© to monitor side effects of oral oncolytics during routine telehealth encounters

Patient reported outcome measures (PROMs) are increasingly used in oncology care, but pharmacists providing direct patient care have been overlooked. We engaged pharmacists and adults receiving oral oncolytics (chemotherapy medication taken by mouth) to develop a SmartForm© in the electronic health...

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Bibliographic Details
Published in:	Quality of life research
Main Authors:	Stover, Angela M, Liang, Debbie, Mueller, Dana, Kurtzman, Rachel, Ikemeh, Christiana, Canter, Courtney, Acharya, Sonali, Brese, Jill, Buhlinger, Kaitlyn, Chen, Kevin, Colmenares, Evan W, Faso, Aimee, Muluneh, Benyam, Patel, Bianka, Reichard, Jeffrey S, Shah, Rushabh M, Tilkens, Michael, Valgus, John, Coombs, Lorinda A, Lafata, Jennifer Elston, Lund, Jennifer L, Ray, Emily M, Mody, Gita, Vest, Mary-Haston
Format:	Journal Article
Language:	English
Published:	Netherlands 15-10-2024
Subjects:	Oral drug administration Patient reported outcome measures Antineoplastic chemotherapy Clinical pharmacy services Neoplasms Quality of life
Online Access:	Get full text
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Summary:	Patient reported outcome measures (PROMs) are increasingly used in oncology care, but pharmacists providing direct patient care have been overlooked. We engaged pharmacists and adults receiving oral oncolytics (chemotherapy medication taken by mouth) to develop a SmartForm© in the electronic health record (EHR) for PROM monitoring. Pharmacists verbally ask the patient side effect questions during routine telehealth encounters and enter responses in real time. Our development process was guided by the Knowledge to Action Framework. In phase 1 (Knowledge Inquiry), we prioritized side effects to assess in the EHR SmartForm© via interviews with patients and a Delphi panel with pharmacists. Adults receiving oral oncolytics for breast (n = 12), thoracic (n = 12), or hematological (n = 12) cancer were interviewed, with purposeful sampling for adults who were aged 65 + years or Black. Interviews were coded with content analysis. We conducted three Delphi rounds, with 11/19, 13/19, and 19/19 pharmacists, respectively. In phase 2 (Knowledge Synthesis), PROM items were selected and the EHR SmartForm© programmed. In phase 3 (Knowledge Tailoring), we conducted usability testing with pharmacists. Pharmacists and patients were consistent in prioritizing side effects of oral oncolytics and 10 were retained. Patients advocated asking whether they can do their usual activities, while pharmacists added medication adherence. Usability testing yielded suggestions to simplify the SmartForm©. By presenting screenshots of our SmartForm©, our findings are useful to other healthcare systems looking for a PROM solution integrated in the EHR, with a reasonable pharmacist/clinician workload, and no requirement for patients to have internet access/comfort.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0962-9343 1573-2649 1573-2649
DOI:	10.1007/s11136-024-03789-8