Stronger together: Implementing patient-reported symptom tool in routine cancer care in diverse Asia—A multi-national pilot feasibility study (PROMiSE-Pilot).

TPS180 Background: Patients diagnosed with cancer often experience disease or treatment-related symptoms, which can be under-elicited and under-appreciated by clinicians during time-poor consultations. This is particularly challenging in Asia where structural disparities in healthcare access mean oncology services are often under-resourced. Five oncologists from Thailand, India, Singapore, Philippines and Australia formed a working group as part of ASCO Asia-Pacific Leadership Development Program (LDP-AP). Systematic symptom monitoring using patient-reported outcomes measures (PROM) was identified as a potential solution to improve care in diverse Asian settings. PROM has demonstrated improved outcomes in Western settings but its utility in resource limited Asian contexts is less well established. A study was developed to evaluate the feasibility of implementing PROM in routine outpatient care across diverse cultural contexts in Asia. Methods: PROMiSE-Pilot is a prospective, multi-centre, feasibility study of integrating PROM in routine outpatient care across Asia. The Edmonton Symptom Assessment Scale questionnaire (ESAS-r) was selected as the PROM tool. Clinicians in 4 hospitals in Singapore, Manila, Bangkok and Hyderabad will be invited to participate, and their patients will be invited to complete the ESAS-r on paper before each visit. The primary aim is to evaluate if proportion of patients who complete ≥5 of 10 items on ESAS-r is ≥85% (Clopper Pearson). Secondary aims include assessing proportion who complete ≥8 and all 10 items and perceived utility of ESAS-r evaluated through surveys adapted to measure patient and clinician satisfaction. Site-specific patient, clinician, administrative barriers and facilitators will be studied. A pragmatic approach to context-specific implementation was adopted with each site developing its own process map for delivering the pilot and adapting to local patient demographics (e.g. low literacy), cultural contexts and resources. Translated versions of ESAS-r were acquired where necessary. Recruitment commenced in March 2024 following ethics approval at 2 sites. 87 patient encounters have been captured from 5 participating clinicians in Singapore. 5 clinicians have agreed to participate in Bangkok. Target recruitment is 200 encounters per site. Multi-centre data will be presented at the Breakthrough congress. Clinicians from ASCO LDP-AP identified PROM as a low-cost but potentially high-value approach to improving quality of care in resource limited settings in Asia. Understanding the feasibility of such a tool is vital prior to consideration of wider scale adoption by stakeholders. This co-developed multi-national pilot additionally demonstrates the value of collaboration, our strength in diversity and a pragmatic model for investigator-initiated studies in Asia.