DF/HCC Program Affiliation

Prostate Cancer

Lab Website

Cantor Center

Research Abstract

ELECTRONIC SELF-REPORT ASSESSMENT FOR CANCER (ESRA-C): IMPROVING PATIENT-CLINICIAN COMMUNICATION
Aims: Assessment of common cancer symptoms and quality of life (QOL) during therapy, notably psychosocial concerns, is known to be incomplete at times. Electronic self-report methods for patients are now available, yet evidence that such methods improve patient/clinician communication is lacking. A confidential, electronic self-report method for patients to report symptoms and concerns, ESRA-C, has been created, and we report on a randomized clinical trial (RCT) of its effectiveness.
Methods: A RCT was conducted at two urban cancer care institutions in adult patients with all types and stages of cancer. Participants completed two assessments, about 6 weeks apart, one prior to treatment and one during treatment, containing validated symptom and QOL measures on touch-screen computers. A graphical, color summary of participant responses was given to clinicians who assessed intervention group patients, versus no summary in the control group. Same-day clinic visits were audio-recorded and then coded by those blind to study group for frequency of symptom/QOL assessment, plus frequencies of therapies to correct troublesome symptoms and side effects and the referrals made for significant quality of life concerns. Generalized Estimating Equations (GEE) and logistic regression modeled the odds of discussion of 27 symptom and QOL concerns by study arm.
Results: 590 participants (294 control & 296 intervention) were assessed by 76 clinicians. The null hypothesis that study arm had no effect was rejected, p=.024. In the intervention group, electronic screening and graphical reporting of cancer symptoms and QOL concerns via the ESRA-C summary had a significant, positive effect on patient/clinician communication. Therapies and referral rates are being analyzed now.
Conclusion: The ESRA-C is the first clinical self-report assessment to be tested in an RCT with directly measured communication outcomes in all services of a comprehensive cancer center.

Publications

• Henrikson NB,Ellis WJ,Berry DL."It's not like I can change my mind later": Reversibility and decision timing in prostate cancer treatment decision-making.Patient Educ Couns 2009 Apr 20.
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• Wolpin S,Berry D,Austin-Seymour M,Bush N,Fann JR,Halpenny B,Lober WB,McCorkle R.Acceptability of an Electronic Self-Report Assessment Program for patients with cancer.Comput Inform Nurs 2008 Nov-Dec;26(6):332-8.
  19047882
• Fann JR,Berry DL,Wolpin S,Austin-Seymour M,Bush N,Halpenny B,Lober WB,McCorkle R.Depression screening using the Patient Health Questionnaire-9 administered on a touch screen computer.Psychooncology 2009 Jan;18(1):14-22.
  18457335
• Berry DL,Ellis WJ,Russell KJ,Blasko JC,Bush N,Blumenstein B,Lange PH.Factors that predict treatment choice and satisfaction with the decision in men with localized prostate cancer.Clin Genitourin Cancer 2006 Dec;5(3):219-26.
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