Patients with cancer were admitted to the emergency department and hospitalized less frequently, and stayed on chemotherapy longer when they self-reported symptoms during cancer treatment using tablet computers, a new study has found.1
Between September 14, 2007 and January 6, 2011, 766 patients initiating chemotherapy at Memorial Sloan Kettering Cancer Center for metastatic breast, genitourinary, gynecologic, or lung cancers were randomly assigned to usual treatment without self-reporting symptoms, or given tablets to self-report symptoms via a web-based interface.
Patients reported frequency and severity of 12 common symptoms experienced during chemotherapy: appetite loss, constipation, cough, diarrhea, dyspnea, dysuria, fatigue, hot flashes, nausea, pain, neuropathy, and vomiting. The study’s primary outcome was health-related quality of life (HRQL) at 6 months from baseline. HRQL improved for 34% of patients in the intervention group, compared to 18% of patients who received usual care.
“Prior work has shown that as oncologists, we miss up to half of our patients’ symptoms during treatment, and particularly those symptoms that people experience between visits,” said Ethan Basch, MD, MSc, of the Lineberger Comprehensive Cancer Center, University of North Carolina in Chapel Hill, NC, and the study’s lead author, in an interview with Cancer Therapy Advisor.
“As it stands now, it’s on the patient to call or bring something up to the physician, and unfortunately things often [go unreported]. By using these remote monitoring approaches, we bring in the ability to systematically collect this information over time, to get people involved in their own care, and to flag things that are concerning,” he said.
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Sixty-three percent of patients using the tablets reported severe symptoms during the study. In response to alerts for severe or worsening symptoms, nurses directly intervened by way of telephone counseling (77% of the time), medication changes (12%), referrals to the emergency department or hospital (8%), dose modification (2%), or imaging/test orders (2%).