Implementing integrated proactive supportive care pathways in oncology: Results from the PROACT-PRO.GNOSIS prospective cohort study.

Abstract

e24104 Background: Can we limit the decrease of quality of life during anticancer treatments? Early assessment of risk factors and patient needs is central to providing efficient, patient-tailored supportive care. We have developed an integrated, coordinated supportive care pathway (PROGNOSIS) that combines a digital self-assessment of the patient's symptoms and tailored supportive care shortly after diagnosis aiming at preventing treatment-related burden. The primary objective of this study is to evaluate the impact of the PROACT-PROGNOSIS pathway on patients' distress and unmet needs after 12 weeks of intervention. PROACT-PROGNOSIS is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. For this presentation, we will focus on short-term efficacy. Methods: All patients aged ≥ 18 years 2) with histological confirmation of cancer, received a self-assessment screener. Vulnerable patients received comprehensive supportive care assessment, invited to participate after written informed consent. Patients are evaluated at baseline, 12, 24 weeks. Quality of life was assessed by EQ5D-VAS (rated out of 100, 0: worst quality of life and 100: perfect quality of life). Participant characteristics were reported as numbers and percentages for categorical variables, and as mean, standard deviation, median, quartiles, minimum and maximum for continuous variables. Results: An efficacy analysis was performed on 68 patients with a Female/Male ratio: 57.4%/42.6 % and of a mean age of 60.2 ±12.8. All cancer type were represented, with a majority of Gastro-intestinal (35.3%), Head and Neck (22.1%), and Thoracic (19.1%) cancers. For patients with sufficient follow-up to have several quality-of-life measurements, we observed a stability of the EQ5D score between M0 and M3 [score stability on average. Mean Score (SD) 3.6 (+/- 23.1). Median (Q1; Q3) 0.0 (-10.0; 10.0)] and between M3 and M6 [slight increase in the score of 4.5 points on average. Median (Q1; Q3) 2.5 (-10.0; 10.0)]. Unscheduled hospitalizations / visits and toxicity impact were also recorded. Conclusions: This preliminary analysis suggests that a journey including early assessment, at cancer diagnosis, followed by a personalized pathway related to supportive care needs may contribute to maintenance of Quality of life at short-term evaluation during anticancer treatment. These results suggest a decrease of complications related to anticancer-treatment rate allowed by early supportive care management with a potential positive impact on survivorship.