Symptom Management Implementation of Patient Reported Outcomes in Oncology



Status:Not yet recruiting
Conditions:Cervical Cancer, Cancer, Cancer, Cancer
Therapuetic Areas:Oncology
Healthy:No
Age Range:18 - Any
Updated:2/28/2019
Start Date:September 1, 2019
End Date:September 30, 2023
Contact:Deborah Schrag, MD, MPH
Email:deb_schrag@dfci.harvard.edu
Phone:617-582-8301

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SIMPRO Research Center: Integration and Implementation of PROs for Symptom Management in Oncology Practice

Deficits in the management of common symptoms cause substantial morbidity for cancer
patients.Because the health care delivery system is structured to be reactive and not
proactive, there are missed opportunities to optimize symptom control. Growth in Internet
access and proliferation of smartphones has created an opportunity to re-engineer cancer care
delivery. Electronic symptom tracking and feedback is a promising strategy to improve symptom
control. Electronic patient reported outcome (ePRO) monitoring of cancer symptoms has been
shown to decrease symptom burden, improve quality of life, reduce acute care and even extend
survival. SIMPRO will use functioning ePRO prototypes to create and refine the electronic
symptom management system eSyM

A multi-disciplinary team of investigators from 6 health systems have formed the Symptom
Management IMplementation of Patient Reported Outcomes in Oncology (SIMPRO) Research Center.
SIMPRO will use functioning ePRO prototypes to create and refine the electronic symptom
management system eSyM. eSyM is the name of the platform the team will refine, integrate,
implement and evaluate. eSyM addresses each of the 4 evidence gaps by:

- Implementing eSyM in cancer centers in small, rural or community-based systems.

- Integrating eSyM into the EHR of the predominant vendor used nationwide.

- Leveraging evidence-based tools, patient engagement, and population management.

- Executing this work using the Consolidated Framework for Implementation Research across
all phases to maximize the chances that eSyM and similar systems achieve their intended
goals and decrease the morbidity of cancer treatment at a population level.

This project contains 4 activities:

1. Obtain stakeholder feedback

2. Build and deploy eSyM

3. Pilot test eSyM

4. Pragmatic stepped-wedge cluster randomized trial

Inclusion Criteria:

Activity 1 Population:

- Age ≥ 18 years

- The potential stakeholders are: patient advisory council members, health system
leaders, clinicians, clinic support staff/administration, IT/Informatics staff

Activity 3 Population:

- Age ≥ 18 years

- Priority population will be patients who meet one of the following:

- Diagnosis of thoracic cancer [lung or bronchus] AND is inpatient following
thoracic cancer surgery.

- Diagnosis of gastrointestinal cancer [colorectal, pancreas, liver/biliary,
esophagus,or gastric] AND is inpatient following gastrointestinal cancer surgery.

- Diagnosis of gynecologic cancer [ovary, uterus, or cervix] AND is inpatient
following gynecologic cancer surgery.

- Diagnosis of thoracic cancer [lung or bronchus] AND scheduled to start a new
palliative chemotherapy regimen for thoracic cancer.

- Diagnosis of gastrointestinal cancer [colorectal, pancreas, liver/biliary,
esophagus,or gastric] AND scheduled to start a new palliative chemotherapy
regimen for gastrointestinal cancer.

- Diagnosis of gynecologic cancer [ovary, uterus, or cervix] AND scheduled to start
a new palliative chemotherapy regimen for gynecologic cancer.

- Total population allowed to use eSyM:

- Any cancer patient at any participating site.

Activity 4 Population:

- Age ≥ 18 years

- Priority population will be patients who meet one of the following:

- Diagnosis of thoracic cancer [lung or bronchus] AND is inpatient following
thoracic cancer surgery.

- Diagnosis of gastrointestinal cancer [colorectal, pancreas, liver/biliary,
esophagus,or gastric] AND is inpatient following gastrointestinal cancer surgery.

- Diagnosis of gynecologic cancer [ovary, uterus, or cervix] AND is inpatient
following gynecologic cancer surgery.

- Diagnosis of thoracic cancer [lung or bronchus] AND scheduled to start a new
palliative chemotherapy regimen for thoracic cancer.

- Diagnosis of gastrointestinal cancer [colorectal, pancreas, liver/biliary,
esophagus,or gastric] AND scheduled to start a new palliative chemotherapy
regimen for gastrointestinal cancer.

- Diagnosis of gynecologic cancer [ovary, uterus, or cervix] AND scheduled to start
a new palliative chemotherapy regimen for gynecologic cancer.

- Total population allowed to use eSyM:

- Any cancer patient at any participating site.
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