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Feasibility and Compliance of Automated Measurement of Quality of Life in Oncology Practice

E.P. Wright, P.J. Selby, M. Crawford, A. Gillibrand, C. Johnston, T.J. Perren, R. Rush, A. Smith, G. Velikova, K. Watson, A. Gould, A. Cull

From Cancer Research UK, Clinical Centre in Leeds, St James’s University Hospital, University of Leeds, Leeds; Department of Medical Oncology, Airedale General Hospital, Keighley, England; Cancer Research UK Medical Oncology Unit, Western General Hospital; and Information and Statistics Division, National Health Services Scotland, Edinburgh, Scotland, United Kingdom.

Address reprint requests to E.P. Wright, PhD, Cancer Research UK, Clinical Centre in Leeds, St James’s University Hospital, Beckett St, Leeds, England, LS9 7TF; email: medepw{at}cancermed.leeds.ac.uk.

Purpose: Systematic quality-of-life (QOL) assessment may have value in oncology practice by increasing awareness of a wide range of issues, possibly increasing detection of psychologic morbidity, social problems, and changes in physical status, and improving care and its outcomes. However, logistic problems are substantial. Automated systems solve many of these problems. We field-tested the feasibility and compliance that can be achieved using a computer touchscreen system in two consecutive studies.

Patients and Methods: In study 1, a prospective cohort of 272 patients was offered QOL assessment at each clinic appointment for 6 months. In study 2, all patients (N = 1,291) were offered QOL assessment as part of clinic routine during a 12-week period.

Results: In study 1, 82% of patients agreed to take part, but over time, compliance was poor (median, 40%; mean, 43%) and deteriorated with longer follow-up. In study 2, the overall compliance was greatly increased (median, 100%; mean, 70%), and compliance was retained over multiple visits. In study 1, compliance was better in younger patients, males, and socially advantaged patients, but was not affected by the presence of depression or anxiety, or QOL. In the second study, building on experience in the first study, data collection and storage in the computer system was excellent, achieving 98% of collected data stored in one center. In general, patients were comfortable with the computers and the approach. Data collection on the wards was more difficult and less complete than in clinics, especially for patients undergoing acute admissions.

Conclusion: Feasibility with higher compliance was demonstrated in study 2, in which the data collection was integrated into routine care, and can be improved with further technical initiatives and education of staff.

Supported by a grant from the National Health Services National Research and Development Programme (E.P.W., A.S., and K.W.), Cancer Research UK (G.V., A.C., and P.J.S.), and the National Lotteries Charities Board (G.V.).

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