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      A narrative review of current evidence supporting the implementation of electronic patient-reported outcome measures in the management of chronic diseases

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          Abstract

          An application of telemedicine of growing interest and relevance is the use of personal computers and mobile devices to collect patient-reported outcomes (PROs). PROs are self-reports of patients’ health status without interpretation by anyone else. The tools developed to assess PROs are known as patient-reported outcomes measures (PROMs). The technological innovations that have led to an increased ownership of electronic devices have also facilitated the development of electronic PROMs (ePROMs). ePROMs are a conduit for telemedicine in the care of patients with chronic diseases. Various studies have demonstrated that the use of ePROMs in routine clinical practice is both acceptable and feasible with patients increasingly expressing a preference for an electronic mode of administration. There is increasing evidence that the use of electronic patient-reported outcome (ePROMs) could have significant impacts on outcomes valued by patients, healthcare providers and researchers. Whilst the development and implementation of these systems may be initially costly and resource-intensive, patient preferences and existing evidence to support their implementation suggests the need for continued research prioritisation in this area. This narrative review summarises and discusses evidence of the impact of ePROMs on clinical parameters and outcomes relevant to chronic diseases. We also explore recently published literature regarding issues that may influence the robust implementation of ePROMs for routine clinical practice.

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          Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial.

          There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited.
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            Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment.

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              The impact of measuring patient-reported outcomes in clinical practice: a systematic review of the literature.

              The purpose of this paper is to summarize the best evidence regarding the impact of providing patient-reported outcomes (PRO) information to health care professionals in daily clinical practice. Systematic review of randomized clinical trials (Medline, Cochrane Library; reference lists of previous systematic reviews; and requests to authors and experts in the field). Out of 1,861 identified references published between 1978 and 2007, 34 articles corresponding to 28 original studies proved eligible. Most trials (19) were conducted in primary care settings performed in the USA (21) and assessed adult patients (25). Information provided to professionals included generic health status (10), mental health (14), and other (6). Most studies suffered from methodologic limitations, including analysis that did not correspond with the unit of allocation. In most trials, the impact of PRO was limited. Fifteen of 23 studies (65%) measuring process of care observed at least one significant result favoring the intervention, as did eight of 17 (47%) that measured outcomes of care. Methodological concerns limit the strength of inference regarding the impact of providing PRO information to clinicians. Results suggest great heterogeneity of impact; contexts and interventions that will yield important benefits remain to be clearly defined.
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                Author and article information

                Contributors
                Journal
                Ther Adv Chronic Dis
                Ther Adv Chronic Dis
                TAJ
                sptaj
                Therapeutic Advances in Chronic Disease
                SAGE Publications (Sage UK: London, England )
                2040-6223
                2040-6231
                24 May 2021
                2021
                : 12
                : 20406223211015958
                Affiliations
                [1-20406223211015958]Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, UK National Institute for Health Research (NIHR) Applied Research Centre, West Midlands, UK
                [2-20406223211015958]Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, USA Vanderbilt O’Brien Center for Kidney Disease, Nashville, TN, USA
                [3-20406223211015958]Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
                [4-20406223211015958]Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
                [5-20406223211015958]Multiorgan Transplant Program, University Health Network and Division of Nephrology, Department of Medicine, University of Toronto, ON, Canada
                Author notes
                Author information
                https://orcid.org/0000-0001-9122-8251
                Article
                10.1177_20406223211015958
                10.1177/20406223211015958
                8150668
                34104376
                622f8ee8-6649-4bcc-928a-f5313047c6de
                © The Author(s), 2021

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 27 October 2020
                : 20 April 2021
                Funding
                Funded by: birmingham biomedical research centre, FundRef https://doi.org/10.13039/501100018952;
                Funded by: NIHR Applied Research Centre, ;
                Funded by: university of birmingham, FundRef https://doi.org/10.13039/501100000855;
                Funded by: university hospitals birmingham nhs foundation trust, FundRef https://doi.org/10.13039/100013963;
                Funded by: UK Research and Innovation, ;
                Funded by: Health Research and Quality/Patient-Centered Outcomes Research Institute Learning Health Systems Scholar K12 award, ;
                Award ID: K12HS026395
                Funded by: canadian institutes of health research, FundRef https://doi.org/10.13039/501100000024;
                Funded by: the Kidney Foundation of Canada, ;
                Categories
                The Role of Telemedicine in Chronic Disease
                Review
                Custom metadata
                January-December 2021
                ts1

                patient-reported outcomes,pros,quality of life,outcome assessment,electronic patient-reported outcomes,epros,eprom systems,digital health,chronic diseases,symptom monitoring

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