Evolving person-focused cancer care: the multifaceted benefits of electronic PRO integration and radiation therapist-led follow-up in radiotherapy

Introduction Evidence regarding radiation therapist (RTT)-led follow-up utilising electronic patient-reported outcomes (ePROs) in radiotherapy is scarce. This study evaluated patient and clinician compliance within a novel ePRO-integrated care pathway for prostate cancer (PCa) patients, exploring its impact on communication, involvement, and post-radiotherapy preferences regarding follow-up.Materials and methods Weekly ePROs were collected via a hospital application during treatment and up to 24 weeks post-radiotherapy. During radiotherapy, RTTs monitored acute toxicity in real-time during weekly ePRO-guided symptom reviews. Compliance was defined as ePROs completed and actively reviewed by the RTT. Patient satisfaction was evaluated using a validated Patient Feedback Form. Four weeks after radiotherapy, patients could choose a structured, RTT-led follow-up consultation.Results Of 287 enrolled patients November 2020 - March 2024, 248 (86%) completed The Patient Feedback Form. During active radiotherapy, the pooled patient ePRO response rate was 84.8% (1548/1826), and the RTT handling rate was 88.4% (1368/1548 questionnaires). Patient post-treatment response rates remained high at weeks 12 (88.7%) and 24 (82.5%). ePRO integration improved communication with RTTs (93.0%), symptom discussion (95.5%), and control over care (93.0%). Among 177 having the choice of follow-up, 73% selected RTT-led follow-up. In logistic regression models, no sociodemographic or clinical factors predicted follow-up preference, though older age showed a trend for RTT-led follow-up selection (aOR 1.05, 95% CI: 0.99-1.11, p = 0.086).Conclusions The ePRO-integrated workflow fostered an empowering clinical environment with strong patient involvement. Our findings demonstrated high patient and RTT compliance across the digital pathway in a diverse prostate cancer cohort that significantly improved patient-clinician communication with a feasible, preference-driven post-treatment follow-up.