Diverse Patient Trajectories during Chemotherapy: Capturing Longitudinal Patient Reported Outcomes
Abstract/Contents
- Abstract
Background
High-value cancer care balances effective treatment with preservation of quality of life. Chemotherapy is known to affect patients’ physical and psychological well-being negatively. Patient-reported outcomes (PROs) provide a means to monitor declines in a patients’ well-being during treatment.
Methods
We identified 741 oncology patients undergoing chemotherapy in our electronic health record (EHR) system who completed PROMIS surveys during treatment at a comprehensive cancer center, 2013-2018. PROMIS surveys were collected before, during, and after chemotherapy treatment. Linear mixed-effects models were performed to identify predictors of physical and mental health scores over time. A k-mean cluster analysis was used to group patient PROMIS score trajectories.
Results
Mean global physical health (GPH) scores were 48.7 (SD 9.3), 47.7 (8.8), and 48.6 (8.9) and global mental health (GMH) scores were 50.4 (8.6), 49.5 (8.8), and 50.6 (9.1) before, during, and after chemotherapy, respectively. Asian race, Hispanic ethnicity, public insurance, anxiety/depression, stage III cancer, and palliative care were predictors of GPH and GMH decline. The treatment time period was also a predictor of both GPH and GMH decline relative to pre-treatment. Trajectory clustering identified four distinct PRO clusters associated with chemotherapy treatment.
Conclusions
Patient-reported outcomes are increasingly used to help monitor cancer treatment and are now a part of care reimbursement. This study leveraged routinely collected PROMIS surveys linked to EHRs to identify novel patient trajectories of physical and mental well-being in oncology patients undergoing chemotherapy and potential predictors. Supportive care interventions in high-risk populations identified by our study may optimize resource deployment.
Description
Type of resource | text |
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Date created | May 19, 2021 |
Creators/Contributors
Author | Azad, Amee Deepak |
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Primary advisor | Kurian, Alison |
Principal investigator | Hernandez-Boussard, Tina |
Subjects
Subject | patient-reported outcomes |
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Subject | chemotherapy |
Subject | PROMIS |
Subject | quality-of-life |
Subject | physical health |
Subject | mental health |
Subject | epidemiology |
Subject | clinical research |
Genre | Thesis |
Bibliographic information
Access conditions
- Use and reproduction
- User agrees that, where applicable, content will not be used to identify or to otherwise infringe the privacy or confidentiality rights of individuals. Content distributed via the Stanford Digital Repository may be subject to additional license and use restrictions applied by the depositor.
- License
- This work is licensed under a Creative Commons Attribution 3.0 Unported license (CC BY).
Preferred citation
- Preferred Citation
- Azad, Amee Deepak and Kurian, Alison and Hernandez-Boussard, Tina. (2021). Diverse Patient Trajectories during Chemotherapy: Capturing Longitudinal Patient Reported Outcomes. Stanford Digital Repository. Available at: https://purl.stanford.edu/xq659bp0211
Collection
Epidemiology & Clinical Research Masters Theses
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- Contact
- adazad12@gmail.com
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