Improving the use of patient-reported outcomes among patients receiving radiation therapy during the COVID-19 pandemic

Introduction: The use of Patient-Reported Outcomes (PROs) is an important part of care for patients receiving radiation therapy. Established processes for patients to complete symptom screening using PROs were disrupted by the COVID-19 pandemic. This study reports the implementation of a Radiation Therapist led "champion " model to support the use of PROs during the COVID-19 pandemic. Methods: Patient charts were audited May 3 to May 22, 2020 to mea-sure the initial impact of the pandemic on weekly completion rates of PROs for patients receiving active radiation treatment. Beginning May 25, 2020, two Radiation Therapists acted as champions to pro-mote the use of PROs among patients and staff. Weekly completion rates of PROs were monitored from May 25, 2020 to May 28, 2021. The type of Patient Reported Outcome Measure (PROM) utilized and treatment intent was also recorded. Results: After implementing the champion model, the weekly completion of PROs increased to an average of 47.0 +/- 11.7 (47.5 +/- 12.6%) from the initial baseline average of 8.7 +/- 1.5 (9.4 +/- 2.1%). For PROs completed, the distribution of PROMs was an average of 37.2 +/- 9.6 (47.7 +/- 12.7%) and 9.8 +/- 3.5 (47.0 +/- 16.9%) for the Revised Edmonton Symptom Assessment Scale (ESAS-r) and the Expanded Prostate Cancer Index Composite (EPIC) respectively. An average of 5.1 +/- 2.9 (26.3 +/- 12.7%) and 41.9 +/- 10.1 (52.4 +/- 14.1%) was recorded for palliative and curative intent respectively. Discussion: An increased number of PROs were completed after implementing the Radiation Therapist led champion model. Patients receiving a radical course of treatment more frequently completed PROs, which in part reflects the longer treatment courses with increased opportunity for PROs to be completed. Conclusion: The Radiation Therapist led champion model sup-ported ongoing monitoring and completion of PROs during the COVID-19 pandemic and has now been integrated into the department's standard clinical practice.