Implementation of the e-IPOS in Home Palliative Cancer Care: A Quasiexperimental Pilot Study.
Letteria Consolo, Daniele Rusconi, Stella Colombo and 6 others
PMID 38504550WHAT IT FOUND
Advanced cancer patients at home completed 82.5% of planned weekly electronic symptom assessments, and 96.9% were complete.
In the intervention group, symptom scores decreased over 4 weeks and unscheduled visits were fewer, but quality of life did not change.
Key findings
01Of 31 eligible patients, 23 consented (74.19%), and the retention rate was 86.96%.
02Patients completed 33 of 40 expected weekly e-IPOS responses (82.5%), and 32 responses were complete (96.97%).
03In patients receiving standard home palliative care plus weekly e-IPOS, overall e-IPOS scores decreased from a mean of 19.4 to 14.1 (median 18.5 to 12.0; P < .001).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Small single-center pilot that was not randomized, so group differences may reflect baseline differences or chance. The paper reports consented patients and deaths before baseline, but does not clearly state how many patients were analysed. Eligibility was judged mainly by clinicians, which may have selected patients more likely to participate. Completion may have been influenced by clinicians prompting patients to complete the e-IPOS weekly during routine home visits. The study did not interview patients about feasibility, usability, usefulness, or the impact of using the e-IPOS. Four weeks of follow-up in terminal illness was too short to detect clear changes in quality of life or performance status. The intervention was standard home palliative care plus weekly e-IPOS with clinician prompting, so the separate contribution of e-IPOS cannot be isolated.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.
The easy way to misread this
Do not conclude that weekly e-IPOS use improves palliative cancer outcomes. This pilot was small and non-randomized, and patients receiving standard home palliative care plus weekly e-IPOS also had clinicians prompting completion during visits; quality of life did not change.