{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T23:25:01Z","timestamp":1792106701984,"version":"4.4.0"},"reference-count":27,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,3,20]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The global burden of cancer is increasingly concentrated in low-income and middle-income countries (LMICs), where health systems face significant challenges such as late-stage diagnosis, limited resources and restricted access to specialised care. Palliative care plays a vital role in improving symptom control and quality of life for patients with cancer, particularly as care delivery shifts toward ambulatory and community-based settings. In this context, patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are crucial for capturing patients\u2019 perspectives on the quality of care. However, the use and characteristics of these instruments in ambulatory palliative care settings within LMICs remain poorly understood. This systematic review aims to identify and map PROMs and PREMs used among adult patients with cancer receiving ambulatory palliative care in LMICs, and to examine their content, psychometric properties and alignment with key domains of quality palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>This systematic review protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) guidelines. The search will be conducted across seven databases from the database inception to December 2025. Two independent reviewers will screen titles, abstracts and full-text articles using Rayyan software to identify studies involving adults (\u226518 years) with cancer in ambulatory palliative care settings. Data extraction will capture study characteristics, instrument content and psychometric properties. The final review will be reported in accordance with the PRISMA-COSMIN for Outcome Measurement Instruments. A narrative synthesis will be conducted, mapping the identified instruments against the eight domains of the National Consensus Project Clinical Practice Guidelines for Quality Palliative Care to identify measurement gaps and inform future instrument development. A meta-analysis will be conducted if sufficient homogeneity exists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This review will include only published data; therefore, no approval is required. The findings of this review will be presented at conferences and published in an open-access peer-reviewed journal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420251273579.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-117726","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T16:16:02Z","timestamp":1776356162000},"page":"e117726","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) used in ambulatory palliative care for adult patients with cancer in low-income and middle-income countries: a systematic review protocol"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2329-6620","authenticated-orcid":false,"given":"Mebin","family":"Mathew","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9975-2568","authenticated-orcid":false,"given":"Arun","family":"Ghoshal","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnblack K","family":"Kabukye","sequence":"additional","affiliation":[{"name":"The Swedish Program for ICT in Developing Regions (SPIDER), Department of Computer and Systems Sciences, Stockholm University, Kista, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nakshatra","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8476-0757","authenticated-orcid":false,"given":"Vijay Shree","family":"Dhyani","sequence":"additional","affiliation":[{"name":"Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santam","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dasharathraj K","family":"Shetty","sequence":"additional","affiliation":[{"name":"Department of Data Science and Computer Applications, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Balaji","family":"B","sequence":"additional","affiliation":[{"name":"Manipal School of Information Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Salins","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine and Supportive Care, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"2026070902001574000_16.4.e117726.1","doi-asserted-by":"publisher","DOI":"10.3322\/CAAC.21834"},{"key":"2026070902001574000_16.4.e117726.2","unstructured":"World Health Organization . 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