A realist evaluation to understand the implementation of PROMS in oncology clinical practice: an implementation science project

1-2024 to 6-2026
 

Background 
The implementation of patient-reported outcome measures (PROMs), including the EORTC PRO measures, has been shown to improve patient-physician communication, health-related quality of life, and survival in several studies. However, integrating PROMs into clinical practice faces significant challenges due to barriers such as technology limitations and uncertainty about their use. While implementation strategies like training and identifying champions have been proposed, their effectiveness varies across clinical contexts. There is a gap in understanding why certain strategies work in some settings and not others, as well as the mechanisms through which these strategies lead to successful implementation. Realist evaluation approaches, which examine how, why, and under what conditions interventions succeed, are increasingly being used to address these questions. 

Aims 
This research aims to develop a "program theory" that explains the conditions under which specific implementation strategies for PROMs are successful, considering context and underlying mechanisms. The goal is to generate insights that will help tailor implementation strategies to different clinical environments, ultimately increasing the uptake of EORTC PROs in practice.
 
Methods 
This research project includes the following studies: 
- Umbrella review: What are the barriers and facilitators to implement PROMS? - Delphi study: What implementation strategies should we use to address the barriers and facilitators to implement PROMS? 
- Realist evaluation: How, why, and under what circumstances do the implementation strategies work?

EORTC Quality of Life Group