Abstract
BACKGROUND: Patient-reported outcome measures (PROMs) are increasingly valued for enhancing patient-centered care and clinical decision-making in oncology. However, routine use remains limited due to implementation challenges. This umbrella review synthesized evidence on barriers and facilitators to PROMs implementation in oncology care using the Consolidated Framework for Implementation Research (CFIR). METHODS: Following PRISMA guidelines (PROSPERO CRD42024539970), we included systematic and scoping reviews published in English up to 25/11/2025 examining PROMs implementation in cancer care. Searches were conducted in MEDLINE, Embase, Cochrane CENTRAL, CINAHL, and Web of Science. Two reviewers independently screened studies, extracted data, and conducted qualitative content analysis, categorizing findings within CFIR domains. Review quality was appraised with AMSTAR 2. RESULTS: Eighteen reviews (2004–2024) were included. Most barriers and facilitators (n = 34) were mapped to Innovation Characteristics (i.e. features related to the intervention). Key barriers included limited perceived clinical value of PROMs and increased patient burden. Inner Setting (i.e. the context within which the implementation occurs) challenges included poor integration with electronic health records and workflow disruptions, while facilitators encompassed alignment with clinical guidelines and staff training. At the Individual level (i.e. attributes related to individuals involved), limited provider knowledge and low patient e-health literacy were noted. CONCLUSION: Successful PROMs implementation requires raising awareness of their clinical value, seamless integration with health records, workflow optimization, and adequate staff training. Patient support should target e-health literacy and equitable access to digital tools. The overall low quality of existing reviews underscores the need for more rigorous evidence on implementation in oncology.