Feasibility Study of Using Electronic Patient-Reported Outcomes to Screen Patients with Advanced Solid Cancers for Palliative Care Needs

Background: Palliative care delivery in oncology is challenging and referral practices vary widely. Standardized, needs-based screening and triage systems are essential to more effectively address patients' palliative care needs. Objective: Assess the feasibility, acceptability, and appropriateness among patients with advanced solid cancers of using electronic patient-reported outcomes (ePROs) to screen for palliative care needs. Design: We developed a 13-item ePRO palliative care survey to assess multidimensional palliative care needs and conducted a pilot study (n = 25) of a palliative care screening intervention using ePRO monitoring and presentation of ePRO reports to a multidisciplinary care team. Feasibility was assessed through enrollment, retention, and ePRO adherence rates. Acceptability and appropriateness were evaluated through exit surveys of all participants and semistructured interviews of a subset of participants (n = 10). Results: From May 2022 to April 2023, 68% (25/37) of eligible patients consented and enrolled on the ePRO platform. Overall, 96% (22/23; 2 censored for death/hospice) of participants completed the study and 96% of participants met predefined ePRO adherence thresholds. Overall, 84% (21/25) of patients reported a severe response during the study period, of whom 95% (20/21) received supportive services during the study period. Patients found the ePRO palliative survey acceptable and appropriate. Qualitative interviews found patient-identified barriers to the intervention and areas for improvement. Conclusions: Screening patients for unmet palliative needs using ePRO monitoring is feasible, acceptable, and appropriate among patients, but more work is needed to understand the perspectives of diverse patients and how to integrate ePRO palliative care screening into clinical workflows.