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Table 1 Characteristics of studies

From: What are the attitudes of health professionals regarding patient reported outcome measures (PROMs) in oncology practice? A mixed-method synthesis of the qualitative evidence

StudyYearLocation of studySettingStudy designData collection methodCancer streamParticipantsPROM nameAims (verbatim)Was there a clear statement of the aims of the research?Is a qualitative methodology appropriate?Was the research design appropriate to address the aims of the research?Was the recruitment strategy appropriate to the aims of the research?Was the data collected in a way that addressed the research issue?Has the relationship between researcher and participants been adequately considered?Have ethical issues been taken into consideration?Was the data analysis sufficiently rigorous?Is there a clear statement of findings?How valuable is the research?
Quality assessment
Absolom et al. [26]2011UKHospitals (n = 3)QualInterviewsMultipleDoctors (oncologists and surgeons) (n = 12) and nurses (n = 11)Various“This study explores the views of cancer professionals regarding their current roles and responsibilities in the detection and management of ED, use of screening tools and access to expert psychological support”. (p.601)YYYYYNYYYY
Basch et al. [27]2005USACancer Centre in hospitalQualSurvey and team debriefing sessionGyne-cologicalDoctors (oncologists) (n = 5) and nurses (n = 4)CTCAE (selected items), ECOG, EuroQoL EQ-5D and free text space“By measuring patient and staff use of this system, two distinct but interrelated issues may be addressed: the feasibility of patient symptom self-reporting, and the usefulness of the Internet as a medium for PRO collection”. (p.3553)YYYYYNYUYY
Biddle et al. [28]2016UKCentres (n = 2)MMInterviewsMultipleRadiographers (n = 5) and nurses (n = 2)DT and Problem List“This qualitative study aimed to understand how such tools are experienced by patients and clinicians in order to optimise use in the future” (p.59)YYYYYNYYYY
Brundage et al. [29]2019CanadaCancer Centres (n = 4)MMInterviewsProstateDoctors (urologists and oncologists), and nurses (n = 31)EPIC-CP and ESAS“The specific study aims were to (1) evaluate the acceptability and usability of EPIC-CP through a patient ‘exit’ survey and (2) explore the clinicians’ acceptability of the EPIC-CP PRO data and use in clinical practice”. (p.772)YYYYYNYYYY
Carolan and Campbell [30]2016UKPrimary careQual (Phenomenological)InterviewsMultipleGeneral practitioners (n = 7)Various“This study sought to explore GPs’ experiences of assessing psychological distress in cancer patients across the cancer trajectory, including their use of validated screening tools.” (p.392)YYYYYUYYYY
Cox et al. [31]2011UKHospices (n = 3)MMInterviewsLungHealth professionals (n = 13)ESAS and EuroQoL EQ-5D“This study had two aims: (1) to test and evaluate the support provided to patients by the computerized assessment tool (the HealthHUBTM); and (2) to determine the clinical acceptability of the technology in a palliative care setting. This paper will focus on the clinical acceptability of the tool and present the difficulties in evaluating the support the tool provided to patients”. (p.676)yYYYYNYYYY
DuBenske et al. [32]2008USACancer Centres (n = 5)MMInterviewsMultipleDoctors (n = 4) and nurses (n = 3)ESAS, Karnofsky Performance Scale and additional items“This study reports initial findings from implementation of the Clinician Report (CR)—a patient and caregiver status report tool accessible by the oncology clinic team”. (p.679)YYYYYNYYYY
Gamlen and Arber [33]2013UKCommunity- basedQual (Ethnographic)Interviews and observationsMultipleNurses (n = 6)Symptoms and Concerns Checklist“The aim of the study is to explore how specialist cancer nurses carry out first assessments of patients in the community, their use of the Symptoms and Concerns Checklist (SCC) and their views on first assessments”. (p.797)YYYYYYYYYY
Girgis et al. [10]2017AustraliaHospitals (n = 2)MMInterviewsMultipleDoctors (oncologists) n = (3), nurse (n = 1), and health services manager (n = 1)DT, ESAS, Problem Checklist and SCNS-ST9“The aim of this study was to test the feasibility and acceptability of PROMPT-Care (Patient Reported Outcome Measures for Personalized Treatment and Care)”. (p.1)YYYYYNYYYY
Groff et al. [34]2018CanadaCancer Clinics (n = 2)MMInterviewsMultipleDoctors (oncologists) (n = 6), nurses (n = 7), and administrators (n = 3)Canadian Problem Checklist and ESAS“The purpose of this study was to evaluate the sustainability of an SFD program implemented in 2 separate oncology clinics 6 months following the conclusion of the implementation. This study also sought to shed light on the barriers and facilitators to the sustainability of SFD”. (p.142)YYYYYYYYYY
Handberg et al. [35]2018DenmarkHaematological wards in hospitals (n = 2) and primary Care settings (n = 2)Qual (Interpretive Description, Ethnographic)Semi-structured focus group interviews, observations, informal conversations and fieldnotesMultipleNurses and allied health (n = 41)Various“The purpose of this study was to analyze and describe health professionals’ attitudes and perspectives on the complexities of cancer survivorship and rehabilitation needs assessment in a shared cancer care context”. (p.71)YYYYYYYYYY
Hubbard et al. [36]2014USACentreMMSurveyMultipleHealth professionals (n = 13 estimated)SAQ“We set out to determine the impact of PRO assessment on routine clinical practice”. (p.248)YYYYYNYUYY
Jagsi et al. [37]2013USASample from various from practice settingsQualInterviewsMultipleDoctors (oncologists) (n = 17)Various“In this study, we conducted semi-structured interviews to investigate practicing oncologists’ perceptions of PROs, with a focus on identifying the critical features to ensure acceptance of the collection of PROs within the context of routine oncology clinical practice”. (p.290)YYYYYYYYYY
Javid et al. [38]2017USASample from various from practice settingsQualWeb conference discussion and stakeholder panelBreastDoctors (surgeons) (n = 12)Breast-Q“We conducted an exploratory qualitative study in order to better understand what HRQOL domains and processes of care define high quality surgical care for women undergoing mastectomy for breast cancer from both the patient and clinician perspective”. (p.127)YYYYYNYUUY
Kallen, et al. [39]2012USAPalliative Care ClinicMMInterviewsMultipleDoctors (n = 4) and nurses (n = 5)Various“Our project’s specific aims were to: (1) define a PRO-based palliative/hospice care model for use in developing the prototype software and (2) evaluate the prototype software in terms of the system’s usability and usefulness”. (p.168)YYYUYNUUYY
Kendall et al. [40]2013UKPrimary care (n = 13)MMInterviewsMultipleHealth Professionals (n = 29)Cancer Ongoing Review Document“This project aimed to assess the feasibility of early proactive follow-up in primary care using a structured template, from the perspective of patients with a new diagnosis of any cancer, their relatives and their primary care teams”. (p.303)YYYYYYYYYY
Kettis-Lindblad et al. [41]2007SwedenHospitals (n = 2)Qual (Interpretivist)InterviewsMultipleDoctors (n = 6)SEIQoL–DW and Disease-related SEIQoL-DW“Overall, this study explored patients’ and oncologists’ perceptions of individualized QOL assessments—the SEIQoL Direct Weight (SEIQoL–DW) and the Disease-Related (DR) SEIQoL-DW—to support the consultation” (p.282)YYYYYNYYYY
Korzeniowski et al. [42]2016CanadaCancer CentreQualInterviewsProstateDoctors (oncologists and a resident) (n = 6) and nurses (n = 4)EPIC-26“The purpose of this study was to pilot-test the use of EPIC-26 in a clinical context in order to assess the acceptability and added value of measuring EPIC-26 scores in practice from clinician and patient perspectives”. (p.1983)YYYYYUYYYY
Kotronoulas et al. [43]2017UKHospitals (n = 3)MMGroup interview and interviewsMultipleNurses (n = 7)Supportive Care Needs SurveyThus, we aimed to explore the feasibility and acceptability of the use of supportive care needs PROMs by colorectal cancer nurse specialists (CNS) in the delivery of supportive care to people with CRC receiving adjuvant chemotherapy.YYYYYYYYYY
Maguire et al. [44]2008UKSites (n = 6)MMInterviews and semi-structured questionnairesMultipleNurses (questionnaire pre- n = 28, post n = 22, and interviews, n = 10)Symptom questionnaire ASyMS“This paper focuses on one of the secondary aims of the study, which was to explore the perceptions of nurses who participated in the study and who used ASyMS& to manage chemotherapy-related toxicity in clinical practice”. (p.382)YYYYYNYYYY
Maguire et al. [45]2015UKClinical Centres (n = 5)MMInterviews and focus groupLungHealth professionals (n = 13)MSAS, Short Form and the Rotterdam Symptom Checklist Activity Subscale (ASyMS)“Therefore, the primary aim of this study was to develop and explore the feasibility and acceptability of the ASyMS in patients with lung cancer receiving radiotherapy (ASyMS-R) and with clinicians involved in their care. A secondary aim was to explore changes in PROMs during the implementation of ASyMS-R, which could eventually inform the design and primary endpoints of future randomized controlled trials”. (E38)YYYYYNYYYY
McCarthy et al. [46]2016AustraliaOncology Centres in hospitals (n = 3)MMInterviews and focus groupsPaediatricsHealth professionals (interviews n = 26 and focus groups n = 32)Psychosocial Assessment Tool“Study aims were to (1) investigate the feasibility (acceptability, brevity, simplicity) of administering the PAT2.0 psychosocial screener to parents following their child’s cancer diagnosis and to (2) examine oncology health-care professionals’ (HCPs) perspectives on the feasibility (acceptability availability, value, relevance) of the PAT2.0 screening tool in their clinical setting”. (p.364)YYYYYNYYYY
Meldahl et al. [47]2013USASample from various from practice settingsQualFocus groupsMultipleDoctors (oncologists) (n = 20)Various“Therefore, our objectives were: (1) to explore oncologists’ understanding and attitudes toward PRO measures, and (2) to understand the impact of PRO data on clinical decision-making”. (p.725)YYYYYNUYYY
Noble-Jones et al. [48]2019UKClinicQualInterviewsGenito-urinaryHealth professionals (lymphoedema and urology) (n = 5)Lymphoedema Genitourinary Cancer Questionnaire“However, the LGUCQ had not been formally evaluated in an urooncology department to identify the benefits (or not) from the perspective of the patients and health professionals (urology and lymphoedema). Including acceptability” (p.5)YYYYYYNYYY
Osborne et al. [49]2014UKOrganisations (n = 3) including, inpatient and outpatient and hospice settingsQualInterviews and focus groupMyelomaDoctors, nurses and allied health (n = 6)EORTC-QLQ-C30, MY24, POS, QOL q“Aims of the present study are to (1) explore the issues important to QOL from the perspective of people with multiple myeloma, and (2) explore the views of patients and clinical staff on existing QOL questionnaires and their use in clinical practice”. (p.2)YYYYYNYYYY
Semple et al. [50]2018Northern IrelandClinicMMInterviewsOral/ Oro-phryngealDoctors (n = 2) and a nurseUWQOLv4, Patient Concern Inventory“Test the feasibility of using a disease- specific HRQOL tool and holistic item prompt list, for personalised identification and prioritisation of post- treatment concerns and issues, on a touchscreen computer, to promote patient empowerment and enablement, during routine surgical post- treatment follow- up clinic for oral and oropharyngeal cancer”. (p.3)YYYUYNYUYY
Snyder et al. [51]2013USACancer Centre in hospitalMMInterviewsMultipleClinicians (n = 12) including medical oncologists and nurse practitionersPatientViewpoint: Patient Reported Outcomes Measurement Information System + BR23 or the EPIC short-form.“After developing a prototype website and conducting usability testing, [8] we sought to conduct the initial pilot-test of PatientViewpoint in practice to assess its feasibility and value. We examined the web tool’s use, usefulness, and acceptability”. (p.2)YYYYYNYUYY
Stover et al. [52]2015USACancer Clinics (n = 3)QualQuestionnairesMultipleDoctors (n = 8) and nurse practitioners (n = 4)Items from PRO-CTCAE and PROMIS and authors own“Our primary objectives were the following: (1) solicit feedback from cancer clinicians and patients to develop a web-based screening system for securely administering and summarizing PRO measures for use during routine cancer care; and (2) pilot test the system during outpatient visits to evaluate cancer patients’ and clinicians’ perceptions of the acceptability and value of discussing PRO measures during clinical care”. (not provided)YYYYYNYUUY
Sundberg et al. [53]2015SwedenHospitals (n = 2)MMInterviewsMultipleNurses (n = 8)A standardized symptom and QoL questionnaire“The aim of this study was to test the feasibility and acceptability of an interactive ICT-platform for smartphone use which collect and manage patient reported symptoms during radiotherapy for prostate cancer” (p.523)YYYYYNYYYY
Taylor et al. [54]2017UKCommunity-based palliative careQualInterviewsMultipleDoctor (palliative care) (n = 4), nurses (n = 7) and general practitioners (n = 4)“PainCheck”: an electronic pain monitoring system“To inform the development and implementation strategy of an electronic pain monitoring system, PainCheck, by understanding palliative care professionals’ needs when integrating PainCheck into routine clinical practice”. (p.661)YYYYYUYYYY
Thayssen et al. [55]2016DenmarkPrimary careQualInterviewsMultipleGeneral practitioners (n = 11)Patient questionnaire: ‘DT and ‘Impact Thermometer’ and problem list“To examine how GPs experience to involve a short questionnaire, completed by patients’ prior to a consultation, when addressing the patients’ problems and needs. The aim is to contribute to the knowledge concerning the use of questionnaires as part of clinical cancer care in general practice”. (p.114)YYYYYYYYYY
Thewes et al. [56]2016AustraliaCancer Centres (n = 2) and Cancer Clinics (n = 2)QualInterviewsMultipleClinicians (n = 10) including nurses, social workers, indigenous health workers and allied healthSCNAT-IP Supportive care needs assessment tool for Indigenous People“This study describes patient and staff attitudes towards the acceptability and feasibility of the SCNAT-IP in routine care. Additionally, this study aimed to identify refinements needed to prepare the SCNAT-IP for use in clinical settings”. (p.2)YYYYYYYYYY
Velikova et al. [57]2002UKClinic in HospitalMMInterviewsMultipleDoctors (oncologists) (n = 3)EORTC QLQ-C30 + HADS“This project was therefore undertaken to assess the feasibility of using computer-administered individual QL measurement in oncology clinics with immediate feedback of results to clinicians and to examine the impact of the QL information on the content of the medical consultations and on patient satisfaction with communication”. (p.52).YYYYYNYYUY
Velikova et al. [58]2008UKHospitals (2)QualFocus groupsMultipleDoctors (oncologists) (n = 16)EORTC QLQ-C30“The aim of this qualitative study was to explore what doctors and patients expect and want from routine measurement of QOL in clinical practice. The second aim was to generate ideas and produce recommendations of how to improve the questionnaires specifically for use in clinical practice”. (p.691)YYYYYNYYYY
  1. Abbreviations: ASyMS advanced symptom monitoring system, BR23 Breast-cancer specific module from the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire, CR clinician report, DT distress thermometer, ESAS Edmonton Symptom Assessment Scale, EPIC-CP or – 26 expanded prostate cancer index composite for clinical practice, EQ-5D Euro-QoL EQ-5D health-related quality of life measure, GP general practitioner); HealthHUBTM)A Computerised assessment tool that includes the ESAS and the EQ-5D), HRQOL Health-related quality of life, MM Mixed-methods, MSAS memorial symptom assessment scale, N No, PROMPT-Care patient reported outcome measures for personalized treatment and care, QOL or QL quality of life, Qual Qualitative methods, SAQ symptom assessment questionnaire, SCC symptoms and concerns checklist, SEIQoL-DW schedule for the evaluation of the individual quality of life-direct weighting, SFD screening for distress, U unsure, Y Yes