Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study

Am J Hosp Palliat Care. 2024 Mar 19:10499091241240667. doi: 10.1177/10499091241240667. Online ahead of print.

Abstract

Introduction: Electronic patient-reported outcome measures (e-PROMs) offer advantages in palliative cancer care, including rapid completion, improved data quality and direct storage, improving clinical decision-making. The electronic Integrated Palliative Care Outcome Scale (e-IPOS) in this context enables thorough self-assessment by patients, enhancing symptom management and self-reflection of their current situation.

Aim: To evaluate the feasibility of implementing the e-IPOS in home palliative cancer care.

Outcomes: The primary outcomes included the enrollment consent rate, study retention rate, e-IPOS completion rate and response completeness, and the number of clinical assessments and interventions performed during home visits. The secondary outcomes were the number of unscheduled visits and patients' perceived quality of life.

Design: A two-group quasiexperimental clinical pilot study. The control group received standard palliative care, the intervention group received standard care along with weekly e-IPOS completion during home visits. Both groups were enrolled for 4 weeks.

Setting/participants: Adults with advanced cancer from the home palliative care unit of the Istituto Nazionale dei Tumori of Milan.

Results: Twenty-three patients were enrolled (74.19%), and 20 completed the study (drop-out: 13.04%). 82.5% of the expected e-IPOS responses were received, of which 96.9% were fully complete. In the intervention group, the Wilcoxon test showed an increase in identified needs and documented interventions (P < .05) and a decrease in unscheduled visits (P < .05).

Conclusion: It is feasible to recruit people via home palliative care for an e-IPOS implementation study. Future fully powered studies should investigate the feasibility and assess patients' perceptions of its use to better understand its clinical benefits.

Keywords: electronic health record; neoplasms; palliative care; patient-reported outcome; self-assessment; terminal care.