Skip to main content
Top
Published in: Quality of Life Research 2/2020

Open Access 01-02-2020 | Multiple Myeloma

Strategies to improve patient-reported outcome completion rates in longitudinal studies

Authors: Lene Kongsgaard Nielsen, Madeleine King, Sören Möller, Mary Jarden, Christen Lykkegaard Andersen, Henrik Frederiksen, Henrik Gregersen, Anja Klostergaard, Morten Saaby Steffensen, Per Trøllund Pedersen, Maja Hinge, Mikael Frederiksen, Bo Amdi Jensen, Carsten Helleberg, Anne Kærsgaard Mylin, Niels Abildgaard

Published in: Quality of Life Research | Issue 2/2020

Login to get access

Abstract

Purpose

The quality of patient-reported outcome (PRO) data can be compromised by non-response (NR) to scheduled questionnaires, particularly if reasons for NR are related to health problems, which may lead to unintended bias. The aim was to investigate whether electronic reminders and real-time monitoring improve PRO completion rate.

Methods

The population-based study “Quality of life in Danish multiple myeloma patients” is a longitudinal, multicentre study with consecutive inclusion of treatment-demanding newly diagnosed or relapsed patients with multiple myeloma. Education of study nurses in the avoidance of NR, electronic reminders, 7-day response windows and real-time monitoring of NR were integrated in the study. Patients complete PRO assessments at study entry and at 12 follow-up time points using electronic or paper questionnaires. The effect of the electronic reminders and real-time monitoring were investigated by comparison of proportions of completed questionnaires before and after each intervention.

Results

The first 271 included patients were analysed; of those, 249 (85%) chose electronic questionnaires. Eighty-four percent of the 1441 scheduled PRO assessments were completed within the 7-day response window and 11% after real-time monitoring, achieving a final PRO completion rate of 95%. A significant higher proportion of uncompleted questionnaires were completed after the patients had received the electronic reminder and after real-time monitoring.

Conclusions

Electronic reminders and real-time monitoring contributed to a very high completion rate in the study. To increase the quality of PRO data, we propose integrating these strategies in PRO studies, however highlighting that an increase in staff resources is required for implementation.
Literature
3.
go back to reference Kumar, S. K., Rajkumar, S. V., Dispenzieri, A., Lacy, M. Q., Hayman, S. R., Buadi, F. K., et al. (2008). Improved survival in multiple myeloma and the impact of novel therapies. Blood,111(5), 2516–2520.CrossRefPubMedPubMedCentral Kumar, S. K., Rajkumar, S. V., Dispenzieri, A., Lacy, M. Q., Hayman, S. R., Buadi, F. K., et al. (2008). Improved survival in multiple myeloma and the impact of novel therapies. Blood,111(5), 2516–2520.CrossRefPubMedPubMedCentral
7.
go back to reference Miguel, J. S., Weisel, K., Moreau, P., Lacy, M., Song, K., Delforge, M., et al. (2013). Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): A randomised, open-label, phase 3 trial. The lancet Oncology,14(11), 1055–1066. https://doi.org/10.1016/s1470-2045(13)70380-2.CrossRefPubMed Miguel, J. S., Weisel, K., Moreau, P., Lacy, M., Song, K., Delforge, M., et al. (2013). Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): A randomised, open-label, phase 3 trial. The lancet Oncology,14(11), 1055–1066. https://​doi.​org/​10.​1016/​s1470-2045(13)70380-2.CrossRefPubMed
15.
go back to reference Boland, E., Eiser, C., Ezaydi, Y., Greenfield, D. M., Ahmedzai, S. H., & Snowden, J. A. (2013). Living with advanced but stable multiple myeloma: A study of the symptom burden and cumulative effects of disease and intensive (hematopoietic stem cell transplant-based) treatment on health-related quality of life. Journal of Pain and Symptom Management,46(5), 671–680. https://doi.org/10.1016/j.jpainsymman.2012.11.003.CrossRefPubMed Boland, E., Eiser, C., Ezaydi, Y., Greenfield, D. M., Ahmedzai, S. H., & Snowden, J. A. (2013). Living with advanced but stable multiple myeloma: A study of the symptom burden and cumulative effects of disease and intensive (hematopoietic stem cell transplant-based) treatment on health-related quality of life. Journal of Pain and Symptom Management,46(5), 671–680. https://​doi.​org/​10.​1016/​j.​jpainsymman.​2012.​11.​003.CrossRefPubMed
16.
go back to reference Holmstrom, M. O., Gimsing, P., Abildgaard, N., Andersen, N. F., Helleberg, C., Clausen, N. A., et al. (2015). Causes of early death in multiple myeloma patients who are ineligible for high-dose therapy with hematopoietic stem cell support: A study based on the nationwide Danish Myeloma Database. American Journal of Hematology,90(4), E73–E74. https://doi.org/10.1002/ajh.23932.CrossRefPubMed Holmstrom, M. O., Gimsing, P., Abildgaard, N., Andersen, N. F., Helleberg, C., Clausen, N. A., et al. (2015). Causes of early death in multiple myeloma patients who are ineligible for high-dose therapy with hematopoietic stem cell support: A study based on the nationwide Danish Myeloma Database. American Journal of Hematology,90(4), E73–E74. https://​doi.​org/​10.​1002/​ajh.​23932.CrossRefPubMed
20.
go back to reference Jordan, K., Proskorovsky, I., Lewis, P., Ishak, J., Payne, K., Lordan, N., et al. (2014). Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: Results of a European, multicenter cohort study. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer,22(2), 417–426. https://doi.org/10.1007/s00520-013-1991-4.CrossRef Jordan, K., Proskorovsky, I., Lewis, P., Ishak, J., Payne, K., Lordan, N., et al. (2014). Effect of general symptom level, specific adverse events, treatment patterns, and patient characteristics on health-related quality of life in patients with multiple myeloma: Results of a European, multicenter cohort study. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer,22(2), 417–426. https://​doi.​org/​10.​1007/​s00520-013-1991-4.CrossRef
22.
go back to reference Priscilla, D., Hamidin, A., Azhar, M. Z., Noorjan, K. O. N., Salmiah, M. S., & Bahariah, K. (2011). Quality of life among patients with hematological cancer in a Malaysian hospital. Medical Journal of Malaysia,66(2), 117.PubMed Priscilla, D., Hamidin, A., Azhar, M. Z., Noorjan, K. O. N., Salmiah, M. S., & Bahariah, K. (2011). Quality of life among patients with hematological cancer in a Malaysian hospital. Medical Journal of Malaysia,66(2), 117.PubMed
24.
go back to reference Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute,85(5), 365–376.CrossRefPubMed Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute,85(5), 365–376.CrossRefPubMed
28.
go back to reference Fairclough, D. L. (2010). Design and analysis of quality of life studies in clinical trials (2nd ed.). Boca Raton: Chapman & Hall/CRC.CrossRef Fairclough, D. L. (2010). Design and analysis of quality of life studies in clinical trials (2nd ed.). Boca Raton: Chapman & Hall/CRC.CrossRef
30.
go back to reference Mercieca-Bebber, R. L., Price, M. A., Bell, M. L., King, M. T., Webb, P. M., & Butow, P. N. (2017). Ovarian cancer study dropouts had worse health-related quality of life and psychosocial symptoms at baseline and over time. Asia-Pacific Journal of Clinical Oncology,13(5), e381–e388. https://doi.org/10.1111/ajco.12580.CrossRefPubMed Mercieca-Bebber, R. L., Price, M. A., Bell, M. L., King, M. T., Webb, P. M., & Butow, P. N. (2017). Ovarian cancer study dropouts had worse health-related quality of life and psychosocial symptoms at baseline and over time. Asia-Pacific Journal of Clinical Oncology,13(5), e381–e388. https://​doi.​org/​10.​1111/​ajco.​12580.CrossRefPubMed
31.
go back to reference Mercieca-Bebber, R., Calvert, M., Kyte, D., Stockler, M., & King, M. T. (2018). The administration of patient-reported outcome questionnaires in cancer trials: Interviews with trial coordinators regarding their roles, experiences, challenges and training. Contemporary Clinical Trials Communications,9, 23–32.CrossRefPubMed Mercieca-Bebber, R., Calvert, M., Kyte, D., Stockler, M., & King, M. T. (2018). The administration of patient-reported outcome questionnaires in cancer trials: Interviews with trial coordinators regarding their roles, experiences, challenges and training. Contemporary Clinical Trials Communications,9, 23–32.CrossRefPubMed
32.
go back to reference Mercieca-Bebber, R., Kyte, D. G., Calvert, M. J., Stockler, M., & King, M. T. (2017). Challenges and training needs of study coordinators responsible for administration of patient-reported outcome questionnaires in cancer trials [Conference Abstract]. Quality of Life Research,26(1 Supplement 1), 102. Mercieca-Bebber, R., Kyte, D. G., Calvert, M. J., Stockler, M., & King, M. T. (2017). Challenges and training needs of study coordinators responsible for administration of patient-reported outcome questionnaires in cancer trials [Conference Abstract]. Quality of Life Research,26(1 Supplement 1), 102.
33.
go back to reference Fairclough, D. L., Peterson, H. F., Cella, D., & Bonomi, P. (1998). Comparison of several model-based methods for analysing incomplete quality of life data in cancer clinical trials. Statistics in Medicine,17(5–7), 781–796.CrossRefPubMed Fairclough, D. L., Peterson, H. F., Cella, D., & Bonomi, P. (1998). Comparison of several model-based methods for analysing incomplete quality of life data in cancer clinical trials. Statistics in Medicine,17(5–7), 781–796.CrossRefPubMed
34.
go back to reference Bernhard, J., Cella, D. F., Coates, A. S., Fallowfield, L., Ganz, P. A., Moinpour, C. M., et al. (1998). Missing quality of life data in cancer clinical trials: Serious problems and challenges. Statistics in Medicine,17(5–7), 517–532.CrossRefPubMed Bernhard, J., Cella, D. F., Coates, A. S., Fallowfield, L., Ganz, P. A., Moinpour, C. M., et al. (1998). Missing quality of life data in cancer clinical trials: Serious problems and challenges. Statistics in Medicine,17(5–7), 517–532.CrossRefPubMed
39.
go back to reference Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases,40(5), 373–383.CrossRefPubMed Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases,40(5), 373–383.CrossRefPubMed
40.
go back to reference Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The index of Adl: A standardized measure of biological and psychosocial function. JAMA,185, 914–919.CrossRefPubMed Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A., & Jaffe, M. W. (1963). Studies of illness in the aged. The index of Adl: A standardized measure of biological and psychosocial function. JAMA,185, 914–919.CrossRefPubMed
41.
go back to reference Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist,9(3), 179–186.CrossRefPubMed Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist,9(3), 179–186.CrossRefPubMed
44.
go back to reference Mor, V., Laliberte, L., Morris, J. N., & Wiemann, M. (1984). The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting. Cancer,53(9), 2002–2007.CrossRefPubMed Mor, V., Laliberte, L., Morris, J. N., & Wiemann, M. (1984). The Karnofsky Performance Status Scale. An examination of its reliability and validity in a research setting. Cancer,53(9), 2002–2007.CrossRefPubMed
47.
go back to reference Folmer Andersen, T., Madsen, M., Jørgensen, J., Mellemkjær, L., & Olsen, J. H. (1999). The Danish National Hospital Register: A valuable source of data for modern health sciences. Danish Medical Bulletin,46, 263–268. Folmer Andersen, T., Madsen, M., Jørgensen, J., Mellemkjær, L., & Olsen, J. H. (1999). The Danish National Hospital Register: A valuable source of data for modern health sciences. Danish Medical Bulletin,46, 263–268.
48.
go back to reference Cocks, K., Cohen, D., Wisloff, F., Sezer, O., Lee, S., Hippe, E., et al. (2007). An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-MY20) in assessing the quality of life of patients with multiple myeloma. European Journal of Cancer (Oxford, England: 1990),43(11), 1670–1678.CrossRef Cocks, K., Cohen, D., Wisloff, F., Sezer, O., Lee, S., Hippe, E., et al. (2007). An international field study of the reliability and validity of a disease-specific questionnaire module (the QLQ-MY20) in assessing the quality of life of patients with multiple myeloma. European Journal of Cancer (Oxford, England: 1990),43(11), 1670–1678.CrossRef
49.
go back to reference Postma, T. J., Aaronson, N. K., Heimans, J. J., Muller, M. J., Hildebrand, J. G., Delattre, J. Y., et al. (2005). The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: The QLQ-CIPN20. European Journal of Cancer (Oxford, England: 1990),41(8), 1135–1139.CrossRef Postma, T. J., Aaronson, N. K., Heimans, J. J., Muller, M. J., Hildebrand, J. G., Delattre, J. Y., et al. (2005). The development of an EORTC quality of life questionnaire to assess chemotherapy-induced peripheral neuropathy: The QLQ-CIPN20. European Journal of Cancer (Oxford, England: 1990),41(8), 1135–1139.CrossRef
50.
go back to reference Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care,34(3), 220–233.CrossRefPubMed Ware, J., Jr., Kosinski, M., & Keller, S. D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care,34(3), 220–233.CrossRefPubMed
54.
go back to reference Gulbrandsen, N., Wisloff, F., Brinch, L., Carlson, K., Dahl, I. M., Gimsing, P., et al. (2001). Health-related quality of life in multiple myeloma patients receiving high-dose chemotherapy with autologous blood stem-cell support. Medical oncology (Northwood, London, England),18(1), 65–77.CrossRef Gulbrandsen, N., Wisloff, F., Brinch, L., Carlson, K., Dahl, I. M., Gimsing, P., et al. (2001). Health-related quality of life in multiple myeloma patients receiving high-dose chemotherapy with autologous blood stem-cell support. Medical oncology (Northwood, London, England),18(1), 65–77.CrossRef
55.
go back to reference Wisloff, F., Eika, S., Hippe, E., Hjorth, M., Holmberg, E., Kaasa, S., et al. (1996). Measurement of health-related quality of life in multiple myeloma. Nordic Myeloma Study Group. British Journal of Haematology,92(3), 604–613.CrossRefPubMed Wisloff, F., Eika, S., Hippe, E., Hjorth, M., Holmberg, E., Kaasa, S., et al. (1996). Measurement of health-related quality of life in multiple myeloma. Nordic Myeloma Study Group. British Journal of Haematology,92(3), 604–613.CrossRefPubMed
57.
go back to reference Nielsen, L., Jarden, M., Andersen, C., Frederiksen, H., Gregersen, H., Klostergaard, A., et al. (2018). Quality of life in newly diagnosed and relapsed Danish multiple myeloma patients—A national longitudinal study of Danish Myeloma Study Group [Conference abstract]. HemaSphere,2(S1), 294–295. Nielsen, L., Jarden, M., Andersen, C., Frederiksen, H., Gregersen, H., Klostergaard, A., et al. (2018). Quality of life in newly diagnosed and relapsed Danish multiple myeloma patients—A national longitudinal study of Danish Myeloma Study Group [Conference abstract]. HemaSphere,2(S1), 294–295.
60.
go back to reference Klee, M. C., King, M. T., Machin, D., & Hansen, H. H. (2000). A clinical model for quality of life assessment in cancer patients receiving chemotherapy. Annals of Oncology,11(1), 23–30.CrossRefPubMed Klee, M. C., King, M. T., Machin, D., & Hansen, H. H. (2000). A clinical model for quality of life assessment in cancer patients receiving chemotherapy. Annals of Oncology,11(1), 23–30.CrossRefPubMed
Metadata
Title
Strategies to improve patient-reported outcome completion rates in longitudinal studies
Authors
Lene Kongsgaard Nielsen
Madeleine King
Sören Möller
Mary Jarden
Christen Lykkegaard Andersen
Henrik Frederiksen
Henrik Gregersen
Anja Klostergaard
Morten Saaby Steffensen
Per Trøllund Pedersen
Maja Hinge
Mikael Frederiksen
Bo Amdi Jensen
Carsten Helleberg
Anne Kærsgaard Mylin
Niels Abildgaard
Publication date
01-02-2020
Publisher
Springer International Publishing
Published in
Quality of Life Research / Issue 2/2020
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-019-02304-8

Other articles of this Issue 2/2020

Quality of Life Research 2/2020 Go to the issue