Qualitative Analysis of Practicing Oncologists’ Attitudes and Experiences Regarding Collection of Patient-Reported Outcomes

Copyright © 2013 by American Society of Clinical Oncology

Qualitative Analysis of Practicing Oncologists’ Attitudes and Experiences Regarding Collection of Patient-Reported Outcomes

1. Reshma Jagsi, MD, DPhil⇑,
2. Anne Chiang, MD, PhD,
3. Blase N. Polite, MD, MPP,
4. Bruno C. Medeiros, MD,
5. Kristen McNiff, MPH,
6. Amy P. Abernethy, MD,
7. Robin Zon, MD and
8. Patrick J. Loehrer Sr, MD

+ Author Affiliations

1. University of Michigan, Ann Arbor, MI; Yale Cancer Center, New Haven, CT; University of Chicago, Chicago, IL; Stanford University, Stanford, CA; American Society of Clinical Oncology, Alexandria, VA; Duke University, Durham, NC; Michiana Hematology/Oncology, South Bend; and Melvin and Bren Simon Cancer Center, Indiana University, Indianapolis, IN

1. Corresponding author: Reshma Jagsi, MD, DPhil, University of Michigan North Campus Research Complex, 2800 Plymouth Rd, Building 16, Room 400S, Ann Arbor, MI 48109; e-mail: rjagsi@med.umich.edu.

Abstract

Purpose: There is growing interest in incorporating routine collection of patient-reported outcomes (PROs) into cancer care. Practicing oncologists are a stakeholder group whose views are not well characterized.

Methods: We developed an interview guide after literature review and in-depth interviews with leaders in the field. We conducted 45-minute semistructured interviews with a diverse sample of medical oncologists identified through affiliation with the Quality Oncology Practice Initiative or a minority-based Community Clinical Oncology Program until thematic saturation. Multiple analysts independently reviewed and thematically coded verbatim transcripts.

Results: Seventeen interviews were conducted with oncologists from 15 states. Emergent themes included variable understanding and experience with PROs. There was enthusiasm for the potential of PROs to improve the efficiency and thoroughness of the patient encounter. Fundamental concerns included information overload, possibility of identifying problems without access to intervention, depersonalization of the physician-patient encounter, cost, and inefficiency. Barriers identified included the need for buy-in from other stakeholders in the practice, lack of appropriate referral resources, staffing needs, and technology concerns. Few identified patient compliance, data sharing/privacy, or medical liability as a major barrier to implementation.

Conclusion: Practicing oncologists had variable understanding of the details of PROs but, when introduced to the concept, recognized utility in improving the efficiency and thoroughness of the patient encounter if implemented properly. The time is right to begin pilot testing such measures with community oncologists so they can lend their expertise to national discussions on which measures to use and how best to use them.