Symptom Self-reporting Associated With Clinical Benefits
Symptom self-reporting during cancer care were associated with clinical benefits, a study published in the Journal of Clinical Oncology has shown.1
Although there is a growing interest to improve symptom monitoring during routine cancer care using patient-reported outcomes, there is limited evidence on its impact on clinical outcomes. Therefore, researchers enrolled 766 patients with advanced solid tumors receiving routine outpatient chemotherapy at Memorial Sloan Kettering Cancer Center.
Participants were randomly assigned to report 12 common symptoms via tablet computers or to receive usual care consisting of symptom monitoring at clinician discretion. Participants with computers at home received weekly e-mail prompts to report symptoms between visits. Then, treating physicians received symptom printouts at visits and nurses received e-mail alerts when patients reported severe or worsening symptoms.
Results showed that health-related quality of life improved in 34% of patients in the intervention group compared with 18% of patients in the usual care group, while it worsened in 38% and 53% of patients, respectively (P < .001). There was also a larger drop in mean health-related quality of life among those in the usual care group than those in the intervention group (P < .001).
Researchers found that 34% of patients receiving the intervention were admitted to the emergency department compared with 41% of those in the usual care arm (P = .02), and 45% and 49%, respectively were hospitalized (P = .08). Patients in the intervention arm also remained on chemotherapy longer (P = .002).
The study also demonstrated that nurses frequently initiated clinical actions in response to e-mail alerts about participants' severe or worsening symptoms.
1. Basch E, Deal AM, Kris MG, et al. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial [published online ahead of print on December 7, 2015]. J Clin Oncol. doi: 10.1200/JCO.2015.63.0830.