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

Autor: Stover AM; Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, NC, USA. stoveram@email.unc.edu.; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA. stoveram@email.unc.edu.; Health Policy and Management, University of North Carolina at Chapel Hill, 1103-D McGavran-Greenberg Hall CB #7411, Chapel Hill, NC, 27599, USA. stoveram@email.unc.edu., Liang D; UNC Health Pharmacy Analytics and Outcomes, Chapel Hill, NC, USA., Mueller D; Department of Urology, UNC Chapel Hill, Chapel Hill, NC, USA., Kurtzman R; NORC, Chicago, IL, USA., Ikemeh C; Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, NC, USA., Canter C; NC TraCS, UNC Chapel Hill, Chapel Hill, NC, USA., Acharya S; UNC Health Specialty Pharmacy, Durham, NC, USA., Brese J; UNC Health Specialty Pharmacy, Durham, NC, USA., Buhlinger K; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA., Chen K; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA.; Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA., Colmenares EW; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA.; Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA., Faso A; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA., Muluneh B; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA.; Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA., Patel B; UNC Medical Center Oncology Outpatient Clinics, Chapel Hill, NC, USA., Reichard JS; Department of Pharmacy, UNC Health, Chapel Hill, NC, USA., Shah RM; UNC Health Specialty Pharmacy, Durham, NC, USA., Tilkens M; Department of Pharmacy, UNC Health, Chapel Hill, NC, USA., Valgus J; Department of Pharmacy, UNC Health, Chapel Hill, NC, USA., Coombs LA; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA.; School of Nursing, UNC Chapel Hill, Chapel Hill, NC, USA., Lafata JE; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA.; Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, USA., Lund JL; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA.; Department of Epidemiology, UNC Chapel Hill, Chapel Hill, NC, USA., Ray EM; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA.; School of Medicine, UNC Chapel Hill, Chapel Hill, NC, USA., Mody G; Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC, USA.; School of Medicine, UNC Chapel Hill, Chapel Hill, NC, USA., Vest MH; UNC Health Pharmacy Analytics and Outcomes, Chapel Hill, NC, USA.
Jazyk: angličtina
Zdroj: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation [Qual Life Res] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1007/s11136-024-03789-8
Abstrakt: Purpose: 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.
Methods: 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.
Results: 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©.
Conclusion: 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.
(© 2024. The Author(s).)
Databáze: MEDLINE
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