Cancer Treatment: Electronic Patient-Reported Symptom Monitoring Linked to Increased Survival in Patients

Highlights:

Abnormal cell growth that could spread to other parts of the body could result in cancer.
Electronic patient-reported symptom monitoring was found to be linked with increased survival among cancer patients.
The overall survival of patients in patient-reported groups was around 31.2 months.

Cancer occurs as a result of abnormal cell growth that has the potential to invade or spread to other parts of the body.

The integration of electronic-patient reported symptoms in patients with cancers that could spread was found to be linked to increased survival when compared with the usual care, finds a new study published in the journal JAMA.

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‘Electronic patient-reported symptom monitoring was associated with an increased survival among cancer patients.’

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The study was presented at the 2017 ASCO (American Society of Clinical Oncology) annual meeting.

The symptoms of cancers are usually common among patients who receive treatment. This can be undetected by clinicians upto half the time.

The electronic patient-reported outcomes (PRO) are growing interest for monitoring symptoms. However, the evidence to demonstrate clinical benefit has been limited.

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The research team assessed the overall survival of patients that was associated with electronic patient-reported symptom monitoring when compared to usual care based on follow-up from a clinical trial.

Clinical Trial
The patients who were initiated routine chemotherapy for treating metastatic solid tumors at Memorial Sloan Cancer Center from September 2007 to January 2011 were allowed to participate in the trial.

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The participants were either assigned to the usual care group or the patient reported outcomes (PRO) group.

The patients under the PRO group provided self-report of 12 common symptoms through a web-based PRO questionnaire system.

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When there was a worsening symptom from a patient in the PRO group, there was an email alert that was triggered to a clinical nurse who is responsible for the care of the patient.

The report profiling of each patient’s symptom burden history was given to the treating oncologist at clinic visits.

Study Findings
The overall survival was assessed in June 2016 after which 517 of 766 participants had died. The median follow-up was around 7 years. The overall survival was 31.2 months in the PRO group and around 26 months in the usual care group.

Potential Reason for Increased Survival
The early responsiveness to patient symptoms preventing adverse downstream consequences.

The symptom alerts responded by nurses were around 77% of the time with clinical interventions that includes calls to provide symptom management counseling, supportive medications, chemotherapy dose modifications and other referrals.

Limitations
The study was conducted at a single tertiary care cancer center.

Around 14% of the participants were non-white and 22% had an educational level of high school or less.

The research team also wrote, "Electronic patient-reported symptom monitoring may be considered for implementation as a part of high-quality cancer care."

References

Deborah Schrag, MD, MPH et al. Overall Survival Results of a Trial Assessing Patient-Reported Outcomes for Symptom Monitoring During Routine Cancer Treatment. JAMA, (June 2017); DOI: 10.1001/jama.2017.7156

Source-Medindia