Perspectives of physicians treating lung cancer patients on the clinical use of outcomes: A qualitative study

Abstract

Abstract Background Using patient-reported outcome measures (PROMs) in scales can help personalise patient care pathways, including the frequency and type of clinical review (face-to-face visits, phone calls, or video calls). We aimed to elucidate the perception of the outcomes of physicians who treat lung cancer patients and the impact they have on their quality of life through questionnaires, and to establish relationships (related to the patient, the social and family environment, and the diagnosis and treatment), in addition to relating them to multidimensional aspects of the patient’s experience. Additionally, we also identified barriers and facilitators to using the outcome measures. Methods We conducted 16 semi-structured interviews via videoconferencing. The interviews focused on collecting expert opinions on physicians’ perceptions of their patient’s outcomes and the most relevant risk variables. A qualitative thematic analysis was performed. Results Three primary groups were identified in the interview analysis: patient-related, social and family environment, and diagnosis and treatment. No direct relationship was discovered between the perception of outcomes by physicians and experiences of patients and caregivers. Conclusions PROMs need to be implemented in the daily routine of clinical care because physicians generally focus on clinical outcomes rather than patient-centred outcomes, their experiences, and needs. The digitisation of PROMs can facilitate their use. We conclude that barriers and facilitators are a form of methodological division because, in reality, what we perceive as barriers can also be facilitators, depending on several factors, such as health literacy, digital literacy, and socioeconomic level. The use of PROMs is relevant, provided there is feedback, and the outcomes are subsequently managed with the patient. Digitalising PROMs (ePROMs) and videoconferencing or telemedicine could improve these situations. However, this type of digital instrument cannot address some dimensions that measure the need for a different approach, such as spiritual care for end-of-life patients. Thus, physicians can focus their attention on each patient.