Breast Cancer Research and Treatment

, Volume 134, Issue 3, pp 1327–1335 | Cite as

The impact of an electronic health questionnaire on symptom management and behavior reporting for breast cancer survivors

  • Meredith Bock
  • Dan Moore
  • Jimmy Hwang
  • Dianne Shumay
  • Laurell Lawson
  • Deborah Hamolsky
  • Laura Esserman
  • Hope Rugo
  • A. Jo Chien
  • John Park
  • Pamela Munster
  • Michelle Melisko
Epidemiology

Abstract

Breast cancer (BC) patients experience multiple symptoms as a result of diagnosis and treatment. While surveillance for detecting cancer recurrence is fundamental to follow-up care, managing symptoms, and promoting health behaviors are equally important. UCSF has implemented a secure online health questionnaire enabling BC patients to provide updates of their health history and symptoms. We randomly selected a sample of stage I–III BC patients (n = 106) who completed a questionnaire before a medical oncology visit between August 2010 and January 2011 and consented to have data used for research. We conducted a chart review calculating the number of symptoms reported in the questionnaire, the clinic note only, and both questionnaire and clinic note, excluding chronic symptoms addressed previously. Self-reported data on exercise and alcohol consumption was compared to documentation of these lifestyle factors in clinic notes. Patients reported significantly more symptoms using the online questionnaire (mean = 3.8, range 0–13) than were documented by the provider in clinic notes (mean = 1.8, range 0–7; p < 0.001 for the difference). A regression plot comparing the percentage of symptoms agreed upon by the patient and provider and the percentage of symptoms addressed yields a slope of 0.56 (95 % CI 0.41–0.71). The number of self-reported symptoms correlates with self-reported Karnofsky scale such that the number of symptoms reported by the patient increases linearly with this score until a threshold and it then plateaus (p < 0.001). Exercise behavior and alcohol consumption were reported in 100 % of the online questionnaires, but was documented in only 30/106 (28 %) and 75/106 (70 %) of charts reviewed. In 19/75 (25 %) charts with alcohol consumption documented, there was substantial discordance between patient and clinician reporting. Electronic data collection of BC patient-reported outcomes has a positive effect on symptom management and identification of opportunities for risk-reducing behavior change.

Keywords

Patient-reported outcomes Breast cancer Clinical practice Health information technology 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Meredith Bock
    • 1
  • Dan Moore
    • 2
  • Jimmy Hwang
    • 2
  • Dianne Shumay
    • 2
  • Laurell Lawson
    • 3
  • Deborah Hamolsky
    • 2
  • Laura Esserman
    • 2
  • Hope Rugo
    • 2
  • A. Jo Chien
    • 2
  • John Park
    • 2
  • Pamela Munster
    • 2
  • Michelle Melisko
    • 2
    • 4
  1. 1.School of MedicineUniversity of California, San FranciscoSan FranciscoUSA
  2. 2.Helen Diller Family Comprehensive Cancer CenterUniversity of California, San FranciscoSan FranciscoUSA
  3. 3.Dynamic Clinical SystemsHanoverUSA
  4. 4.Department of Medicine (Hematology/Oncology)University of California, San FranciscoSan FranciscoUSA

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