ESTRO meets Asia 2024 Congress Report

The importance of listening actively to the patient’s voice in all that we do in radiation therapy was an underlying theme throughout the radiotherapist (RTT) track at the ESTRO meets Asia 2024 congress. This was highlighted in this session on patient-reported outcome measures (PROMs), as the speakers encouraged us to discuss the embedding of PROMs into routine clinical practice across the world. The session comprised three presentations. The first provided the historical background to the use of PROMs in radiation therapy and offered glimpses of the future with the increasing adoption of electronic PROMs (ePROMs). The second delivered a real-world demonstration of ePROMs in action. It affirmed the benefits and revealed the challenges that exist. The third, and most impactful, presentation offered the patient’s perspective; it reinforced the view that the incorporation of PROMs is a necessity and not an optional extra.

Assistant professor Elizabeth Forde of Trinity College Dublin, Ireland, opened the dialogue by walking us through how PROMs originated and evolved. She highlighted the many validated questionnaires that have been created to provide centres with tools to unpack the patient’s experience. These included the suite of questionnaires that cover overall patient quality of life and which are offered by the European Organisation for the Research and Treatment of Cancer and numerous site-specific questionnaires that explore the intricacies of different cancers and their effects on people. Prof Forde then extended the conversation to the latest advance, which involves the digital collection of PROMs data, and how the use of this approach has the potential to transform the incorporation of PROMs into everyday practice. She shone a spotlight on The Christie NHS Foundation Trust’s ePROMs platform “My Christie-My Health” as an example of ePROMs in practice.

Dr Jeffrey Tuan, from the National Cancer Centre Singapore, presented his centre’s experience with the implementation of ePROMs in clinical practice. Dr Tuan described the logistical considerations that were required to select a suitable platform for the delivery of ePROMs, and he offered practical tips to delegates who sought to establish similar programmes in their workplaces. Of great interest was the insight the centre has gained regarding the barriers to the routine collection of PROMs data. These included language, health literacy levels and the influence of family culture on the information captured. A barrier that ignited discussion amongst attendees was the length of PROMs questionnaires. The conversation centred on the possibility of using shorter questionnaires that still provided appropriate insight into the patient experience whilst not burdening patients with excessive numbers of questions. This is definitely an area for further investigation and validation.

Finally, and most importantly, delegates heard a patient’s voice as Julie McCrossin gave a glimpse of what treatment is like from a patient’s perspective. Ms McCrossin, a survivor of head-and-neck cancer, described eloquently and impactfully the patient’s opinion of lying on the linac and hence reminded us of why it is essential to listen continually to the patients in our care. She drew attention to other survivors’ experiences of treatment and how it has affected their daily lives in the years after treatment. Ms McCrossin highlighted some wonderful work that is being undertaken in the patient education and ePROMs space at the Princess Alexandra Hospital in Brisbane, Australia, and the efforts there to embed the consideration of patients’ views into routine clinical practice. Her passionate and personal presentation left a lasting impression on those in the audience, many of whom said they would continue the discussion in their workplaces and strive to improve patients’ experiences.

This session demonstrated the extensive benefits of entrenching PROMs in routine clinical practice throughout the world. Conversations about PROMs should be continued globally as we strive to deliver the best possible treatment for our patients and to provide them with the holistic care they deserve.

Author:

Dr Elizabeth Brown (PhD)

Assistant director, radiation therapy

Radiation Oncology Department, Princess Alexandra Hospital

Brisbane, Australia

Email: Elizabeth.Brown3@health.qld.gov.au