OBJECTIVES: Head and Neck cancers (HNCs) account for 4% of all cancers, causing 15,000 deaths annually in the US. Patient-reported outcomes (PROs) may regulate global reimbursement processes for HNCs. This review aims to encapsulate utilization of PROs in HNCs in real-world (RW) setting for supporting reimbursement, and framing health policies.

METHODS:

The review was conducted as per PRISMA. PubMed and Embase database were searched and supplemented by searches on google scholar and HTA websites to include RW studies.

RESULTS: Ten records fulfilled the eligibility criteria. The most recommended and validated PROs were: University of Washington Quality of Life Scale (UW-QoL); European Organization for Research and Treatment of Cancer (EORTC-QLQ-HNC); Functional Assessment of Cancer Therapy-Head and Neck (FACT-HNC). PROs were assessed at various stages of HNC: diagnosis (Satisfaction with Cancer Information profile); treatment (Symptom Severity Scale); drug toxicity (Oral Mucositis Weekly Questionnaire-Head and Neck Cancer); recovery (FACT-HNC); recurrence (Vanderbilt Head and Neck Symptom Survey) and palliation (EORTC QLQ-C15-PAL). Voice, speech and swallowing were perceived to be troublesome and required appropriate PROs (Voice Handicap Index, Speech Handicap Index and Swallowing Questionnaire on QoL) to evaluate their impact on the patients’ QoL. The use of ePROs with patient education was advocated allowing remote and out-of-hospital reporting. PRO measurement during surgical timeline was considered a critical component, necessary to increase the understanding and impact of pre-habilitation interventions. PRO evaluation in a surgical timeline could be improved by effective communication and using activity tracker, substantiating accurate PRO recordings. Other barriers for using PROs were: lack of awareness and resources; unproven or unvalidated PROs.

CONCLUSIONS:

Limited RWE is available for the utilization of PROs in HNCs. Combining PRO outcome measures at different stages may allow for the development of targeted interventions. The use of PROs may tailor rehabilitation and refine future strategies for better patient care.