Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2026

Effectiveness of electronic patient-reported outcome measures for improving real-world routine cancer care: The pragmatic, randomised controlled PROMISE trial. (146181)

Ingrid J Rowlands 1 2 , Amy Brown 3 4 , Bena Brown 2 5 6 , Louisa Collins 2 7 8 , Fiona Crawford-Williams 9 , Melissa Eastgate 2 10 , Afaf Girgis 11 , Gunter Hartel 1 2 8 12 , Reegan Knowles 9 , Rahul Ladwa 2 5 , Therese Lawton 1 , Karen Martin 1 , Peter McGuire 10 , Elizabeth Miller 5 6 , Rebecca Packer 2 , Mark Pinkham 5 9 , Sabe Sabesan 3 4 , Jasotha Sanmugarajah 12 13 , Laurelie Wishart 2 5 12 , David Wyld 2 8 10 , Raymond Chan 5 9 , Penelope Webb 1 2
  1. QIMR Berghofer, Herston, QLD, Australia
  2. The University of Queensland, Brisbane, QLD, Australia
  3. James Cook University, Townsville, QLD, Australia
  4. Townsville University Hospital, Townsville, QLD, Australia
  5. Princess Alexandra Hospital, Brisbane, QLD, Australia
  6. Metro South Health, Brisbane, QLD, Australia
  7. Cancer Council Queensland, Brisbane, QLD, Australia
  8. Queensland University of Technology, Brisbane, QLD, Australia
  9. Flinders University, Adelaide , SA, Australia
  10. Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
  11. University of New South Wales, Sydney, QLD, Australia
  12. Griffith University, Brisbane, QLD, Australia
  13. Gold Coast University Hospital, Southport, QLD, Australia

Aims: To test the effectiveness of integrating electronic patient-reported outcome measures (ePROMs) within the context of real-world cancer care across Queensland, Australia.

Methods: A pragmatic, multi-site randomised controlled trial conducted across four sites. Between August 2021 and June 2023, adults (≥18 years) with newly diagnosed or recurrent solid cancers were randomised 1:1 to receive either an ePROM intervention or usual care. Intervention participants routinely completed ePROMs assessing cancer symptoms and distress during the first six months of care. Alerts were sent to relevant clinicians to follow-up patients when predefined symptom thresholds were exceeded. All participants completed surveys at baseline and at 3, 6, 12, 18, and 24 months. Co-primary outcomes were unplanned hospital presentations identified through linked administrative health records and physical and functional wellbeing measured using the Functional Assessment of Cancer Therapy-General subscales. Secondary outcomes included symptom burden, psychological distress, overall wellbeing, and healthcare experience. Analyses used mixed-effects repeated-measures models and negative binomial regression.

Results: A total of 538 participants were randomised. The ePROM completion rates across sites ranged from 54% to 91% during the first six months. Compared with usual care, the intervention did not reduce unplanned hospital presentations or improve physical and functional wellbeing at six months. However, intervention participants reported significantly lower symptom burden (adjusted mean difference -0.24, 95% confidence interval -0.40 to -0.08) and a better hospital care experience at six months (88% intervention vs 79% usual care rating it ‘very good’). No significant differences between groups existed at other time points or for the other outcomes. 

Conclusions: Integrating ePROMs into routine cancer care resulted in modest short-term improvements in symptom burden and patient experience. While the pragmatic trial enhances real-world relevance, it may explain the smaller effects observed in our study compared with previous trials conducted in settings with a high trial fidelity.