Patient-Reported Experience Measures (PREMs) in patients with metastatic colorectal cancer undergoing treatment supported by feedback auditing: the EPIC study

Background: Patient-reported experience measures (PREMs) offer an objective measure of the patient experience by investigating various fields of the care pathway. We analyzed PREMs in patients with metastatic colorectal cancer (mCRC) undergoing anticancer therapy integrating an auditing process to allow corrective actions. Materials and methods: This is a prospective, observational, monocentric study with a four-phase sequential design: phase I validation of the PREMs questionnaires in five-level Likert item format in Italian; phase II administration of questionnaires at T0 (0-30 days since the start of oncology care), T1 (30 days-6 months), T2 (6-12 months), T3 (>12 months); phase III analysis of results during quality audits and implementation of strategies to improve care pathways; phase IV re-administration and results compared with phase II. Results: PREMs were tested for validity in 47 patients (phase I of the EPIC study). In phase II, 102 patients were enrolled, 150 questionnaires were administered and 142 returned (94.6%). Sixteen questions grouped in four areas (information about care path, contacts and accessibility, patient needs, health care awareness monitoring) were analyzed. A high proportion of patients were concerned about their future/possibility of relapse at T1 (61.6%/58.3%) and T2 (62.5%/63.7%). After the implementation of a checklist for clinicians (phase III), in phase IV, 74 patients were enrolled and the proportion of patients concerned about their future/possibility of a relapse decreased at T1 (35.7%/25%) and T2 (31.3%/43.4%). Conclusions: PREMs evaluation is feasible in the setting of mCRC. A checklist for clinicians tailored after an ad hoc audit improved results about patients’ concerns about their future and possibility of relapse.