In an unique UK trial, it was found that hundreds of cancer patients have benefitted from using computer algorithms to manage their symptoms and improve their wellbeing.
In the trial eRAPID, early stage colorectal, breast or gynecological cancer patients took part, which allowed them to report online symptoms from home and receive instant advice on whether to self-manage or seek medical attention.
The trial developed by the University of Leeds is published in the Journal Of Clinical Oncology.
The result of this trial demonstrated that the patient's physical wellbeing can be improved in a cost-effective way without increasing clinicians' workload. This is the first trial that offers an automated advice, and one of only a few to focus mainly on early-stage patients whose treatment aims to cure the cancer.
The lead author of the trial Professor Galina Velikova, at the Leeds Institute of Medical Research at St James's, University of Leeds, and the Leeds Cancer Centre, Leeds Teaching Hospitals NHS Trust said, "Rising numbers of cancer patients are receiving a range of anti-cancer treatments which means patients are living longer and require longer periods of care and monitoring. Remote online monitoring options have the potential to be a patient-centred, safe and effective approach to support patients during cancer treatment and manage the growing clinical workload for cancer care."
Dr Kate Absolom, University Academic Fellow in the Leeds Institute of Medical Research at St James's and the Leeds Institute of Health Sciences at the University of Leeds said, "The encouraging results from this study will help pave the way for future development and refinement of these interventions in broader cancer settings. The COVID-19 pandemic highlighted the need and speeded a shift towards technology-enabled care, so these study results are very timely."
Cancer patients experience a range of symptoms that can be caused by cancer itself, or by other conditions, or due the side effects from chemotherapy and other treatments, which are sometimes life threatening and require emergency hospitalization. These symptoms can lower patient's quality of life and hence better monitoring and management can improve treatment delivery and reduce patient's physical distress.
The eRAPID Trial
The trial included 508 patients between the ages of 18 to 56 starting chemotherapy at Leeds Cancer Centre. All these patients were given their usual care and 256 patients receiving the eRAPID system as additional care. The study was conducted over a period of 18-weeks in which the participants answered a set of cancer specific questions through an online symptom report once a week, or when new symptoms emerged. A computer algorithm designed by the researchers was used to grade symptom severities and the clinicians scored all the responses and determined the advice patients received.
The questionnaire included pain levels, nausea, spending time in bed and not meeting family needs. The patients were given immediate advice on symptom management or a prompt to contact the hospital. Email alerts for severe symptom reports were sent directly to clinicians and the reports were immediately displayed in the patient's electronic records.
Clinical benefits in patient's physical wellbeing were seen particularly in the early period of treatment, between weeks 6 and 12, during which most of the challenges in controlling side-effects are expected.
The immediate advice given increased the patient's confidence in managing the mild and moderate treatment-related symptoms, which can significantly impact the patient's quality of life and their ability to continue treatment. The trial data also showed no increase in hospital workload, no compromise of patient safety, and no differences in chemotherapy delivery.
Julia Brown, Professor of Clinical Trials Research and Director of the University of Leeds Institute of Clinical Trials Research, in the School of Medicine, said, "This study provides timely and important evidence that remote real-time monitoring of cancer patients, particularly essential during pandemic conditions, is feasible and can improve patients' physical wellbeing."