Numerous distinct electronic systems are currently being used to actively engage patients with cancer in self-report and self-management of treatment-related adverse effects. However, due to the diversity of definitions and assessment tools used across the reviewed systems, these researchers were able to identify common features but could not compare end points related to patient engagement and outcomes. This report was published in the Journal of Medical Internet Research.

Given the potential for wide ranging adverse effects of cancer treatment and its frequent delivery in ambulatory settings, home-based, real-time, electronic assessments of patient-reported outcome measures (PROMs) have the potential to facilitate patient follow-up and enhance patient engagement and support.

This systematic review was conducted to identify and describe currently available electronic PROM-based systems for patients with cancer undergoing treatment, and to evaluate which particular system features were most effective in engaging patients and improving patient-centered outcomes.

“To our knowledge, this is the first systematic review in this field to identify and characterize all available systems for patients to report and manage side effects of cancer treatment, in addition to evidence on patient engagement and patient-centered outcomes,” the authors wrote. 

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The study researchers identified 77 studies describing 41 existing home-based/Web-based electronic systems. Using a taxonomy of features developed as part of this study, they determined that 58% of the systems allowed healthcare providers to monitor patient data over time, but only 46% of them allowed patients to do so. In addition, only 41% and less than one-third of systems included features for delivering advice and providing general education to patients, respectively. Only small percentages (15% or less) of systems facilitated communication between patients and their healthcare providers or other patients.

Of these 77 studies, 21 feasibility studies and 8 controlled trials were included for an assessment of patient engagement and outcomes across different electronic systems. However, the authors determined that, due to the heterogeneity in the descriptions of electronic systems and their associated outcomes, these relationships could not be determined.  

“Based on this review, we recommend that all system evaluations include (1) a description of the system using our taxonomy of system features; (2) measures of feasibility and engagement; (3) patient-centered outcomes focusing on quality of life and symptom improvement, in addition to those focusing on self-efficacy and patient activation; and (4) a measure of health economics. This will facilitate synthesis of evidence in order to improve the design of systems and make them practically useful for both patients and clinicians,” the authors concluded.

Reference

Warrington L, Absolom K, Conner M, et al. Electronic systems for patients to report and manage side effects of cancer treatment: systematic review. J Med Internet Res. 2019;21(1):e10875.