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Erschienen in: Supportive Care in Cancer 9/2014

01.09.2014 | Original Article

Automated monitoring of symptoms during ambulatory chemotherapy and oncology providers’ use of the information: a randomized controlled clinical trial

verfasst von: Kathi H. Mooney, Susan L. Beck, Robert H. Friedman, Ramesh Farzanfar, Bob Wong

Erschienen in: Supportive Care in Cancer | Ausgabe 9/2014

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Abstract

Purpose

Monitoring patient-reported symptoms is necessary to adjust and improve supportive care during chemotherapy. Continuing advances in computerized approaches to symptom monitoring can enhance communication about unrelieved symptoms between patients and oncology providers and may facilitate intensified symptom treatment.

Methods

An automated IT-based telephone monitoring system was developed to enable oncology providers to receive and act on alert reports from patients about unrelieved symptoms during chemotherapy treatment. Daily, 250 participants (randomized to treatment or attentional control) were asked to call the automated system to report presence, severity, and distress for common chemotherapy-related symptoms (1–10 scale if present). For the treatment group, symptoms exceeding preset thresholds for moderate-to-severe intensity levels generated emailed alert reports to both the patient’s oncologist and oncology nurse.

Results

Patients reported high satisfaction and ease of use of the automated system. Over 80 % of providers reported usefulness of the symptom alert reports. Ten monitored symptoms resulted in, on average, nine moderate-to-severe intensity alerts per patient over 45 study days. However, providers rarely contacted patients after receiving alerts. There were no significant differences in change of symptom severity between the two groups (mean difference = 0.06, p = 0.58).

Conclusion

Despite patients’ use of a daily symptom monitoring system and providers’ receipt of information about unrelieved symptoms of moderate-to-severe intensity, oncology physicians and nurses did not contact patients to intensify symptom treatment nor did symptoms improve. Further research is indicated to determine if oncology providers initiated follow-up to intensify symptom treatment, whether symptom outcomes would improve.
Literatur
1.
Zurück zum Zitat Atherton P, Sloan J (2006) Rising importance of patient-reported outcomes. Lancet Oncol 7(11):883–884PubMedCrossRef Atherton P, Sloan J (2006) Rising importance of patient-reported outcomes. Lancet Oncol 7(11):883–884PubMedCrossRef
2.
Zurück zum Zitat Basch E, Abernethy A (2011) Supporting clinical practice decisions with real-time patient-reported outcomes. J Clin Oncol 29(8):954–956PubMedCrossRef Basch E, Abernethy A (2011) Supporting clinical practice decisions with real-time patient-reported outcomes. J Clin Oncol 29(8):954–956PubMedCrossRef
3.
Zurück zum Zitat Bren L (2006) The importance of patient-reported outcomes. It’s all about the patients. FDA Consum 40(6):26–33PubMed Bren L (2006) The importance of patient-reported outcomes. It’s all about the patients. FDA Consum 40(6):26–33PubMed
4.
Zurück zum Zitat Grenhalgh J (2009) The applications of PROs in clinical practice: what are they, do they work, and why? Qual Life Res 18(1):115–123CrossRef Grenhalgh J (2009) The applications of PROs in clinical practice: what are they, do they work, and why? Qual Life Res 18(1):115–123CrossRef
5.
Zurück zum Zitat Trotti A et al (2007) Patient-reported outcomes and the evolution of adverse event reporting in oncology. J Clin Oncol 25(32):5121–5127PubMedCrossRef Trotti A et al (2007) Patient-reported outcomes and the evolution of adverse event reporting in oncology. J Clin Oncol 25(32):5121–5127PubMedCrossRef
6.
Zurück zum Zitat Wu A et al (2012) Adding the patient perspective to comparative effectiveness research. Health Aff 29(10):1863–1871CrossRef Wu A et al (2012) Adding the patient perspective to comparative effectiveness research. Health Aff 29(10):1863–1871CrossRef
7.
Zurück zum Zitat Carpenter JS et al (2008) Oncology outpatient and provider responses to a computerized symptom assessment system. Oncol Nurs Forum 35(4):661–669PubMedCentralPubMedCrossRef Carpenter JS et al (2008) Oncology outpatient and provider responses to a computerized symptom assessment system. Oncol Nurs Forum 35(4):661–669PubMedCentralPubMedCrossRef
8.
Zurück zum Zitat Given C et al (2008) Managing symptoms among patients with breast cancer during chemotherapy: results of a two-arm behavioral trial. J Clin Oncol 26:5855–5862PubMedCentralPubMedCrossRef Given C et al (2008) Managing symptoms among patients with breast cancer during chemotherapy: results of a two-arm behavioral trial. J Clin Oncol 26:5855–5862PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Basch E et al (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol 23(15):3552–3561PubMedCrossRef Basch E et al (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol 23(15):3552–3561PubMedCrossRef
10.
Zurück zum Zitat Basch E et al (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol: Off J Am Soc Clin Oncol 23(15):3552–3561CrossRef Basch E et al (2005) Patient online self-reporting of toxicity symptoms during chemotherapy. J Clin Oncol: Off J Am Soc Clin Oncol 23(15):3552–3561CrossRef
11.
Zurück zum Zitat Berry D et al (2011) Enhancing patient–provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 29(8):1029–1035PubMedCentralPubMedCrossRef Berry D et al (2011) Enhancing patient–provider communication with the electronic self-report assessment for cancer: a randomized trial. J Clin Oncol 29(8):1029–1035PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Mark T, Fortner B, Johnson G (2008) Evaluation of a tablet PC technology to screen and educate oncology patients. Support Care Cancer 16(4):371–378PubMedCrossRef Mark T, Fortner B, Johnson G (2008) Evaluation of a tablet PC technology to screen and educate oncology patients. Support Care Cancer 16(4):371–378PubMedCrossRef
13.
Zurück zum Zitat Finkelstein J, Friedman R (2000) The potential role of telecommunications technologies in the management of chronic health conditions. Dis Manag Health Outcomes 8(2):57–63CrossRef Finkelstein J, Friedman R (2000) The potential role of telecommunications technologies in the management of chronic health conditions. Dis Manag Health Outcomes 8(2):57–63CrossRef
14.
Zurück zum Zitat Main D et al (2005) A qualitative study of work and work return in cancer survivors. Psychooncology 14(11):992–1004PubMedCrossRef Main D et al (2005) A qualitative study of work and work return in cancer survivors. Psychooncology 14(11):992–1004PubMedCrossRef
15.
Zurück zum Zitat Mooney KH et al (2002) Telephone-linked care for cancer symptom monitoring: a pilot study. Cancer Pract 10(3):147–154PubMedCrossRef Mooney KH et al (2002) Telephone-linked care for cancer symptom monitoring: a pilot study. Cancer Pract 10(3):147–154PubMedCrossRef
16.
Zurück zum Zitat Cleeland C et al (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol 29(8):994–1000PubMedCentralPubMedCrossRef Cleeland C et al (2011) Automated symptom alerts reduce postoperative symptom severity after cancer surgery: a randomized controlled clinical trial. J Clin Oncol 29(8):994–1000PubMedCentralPubMedCrossRef
17.
Zurück zum Zitat Kobak KA et al (1996) Computer-administered clinical rating scales. A review. Psychopharmacology (Berl) 127(4):291–301CrossRef Kobak KA et al (1996) Computer-administered clinical rating scales. A review. Psychopharmacology (Berl) 127(4):291–301CrossRef
18.
Zurück zum Zitat Hilarius D et al (2008) Use of health-related quality-of-life assessments in daily clinical oncology nursing practice: a community hospital-based intervention study. Cancer 113(3):628–637PubMedCrossRef Hilarius D et al (2008) Use of health-related quality-of-life assessments in daily clinical oncology nursing practice: a community hospital-based intervention study. Cancer 113(3):628–637PubMedCrossRef
19.
Zurück zum Zitat Velikova G et al (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being:a randomized controlled trial. J Clin Oncol 22(4):714–724PubMedCrossRef Velikova G et al (2004) Measuring quality of life in routine oncology practice improves communication and patient well-being:a randomized controlled trial. J Clin Oncol 22(4):714–724PubMedCrossRef
20.
Zurück zum Zitat Williams E et al (2012) Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: baseline findings and six-month outcomes. BMC Public Health 12:602–612PubMedCentralPubMedCrossRef Williams E et al (2012) Randomised controlled trial of an automated, interactive telephone intervention (TLC Diabetes) to improve type 2 diabetes management: baseline findings and six-month outcomes. BMC Public Health 12:602–612PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Salminen E et al (2008) Needs of developing the skills of palliative care at the oncology ward: an audit of symptoms among 203 consecutive cancer patients in Finland. Support Care Cancer 16(1):3–8PubMedCrossRef Salminen E et al (2008) Needs of developing the skills of palliative care at the oncology ward: an audit of symptoms among 203 consecutive cancer patients in Finland. Support Care Cancer 16(1):3–8PubMedCrossRef
22.
Zurück zum Zitat Teunissen SC et al (2007) Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manag 34(1):94–104CrossRef Teunissen SC et al (2007) Symptom prevalence in patients with incurable cancer: a systematic review. J Pain Symptom Manag 34(1):94–104CrossRef
23.
Zurück zum Zitat Cleeland C, Mendoza T (2011) Symptom measurement by patient report. In: Cleeland C, Fisch M, Dunn A (eds) Cancer symptom science: measurement, mechanisms and management. Cambridge University Press, Cambridge, pp 271–289 Cleeland C, Mendoza T (2011) Symptom measurement by patient report. In: Cleeland C, Fisch M, Dunn A (eds) Cancer symptom science: measurement, mechanisms and management. Cambridge University Press, Cambridge, pp 271–289
24.
Zurück zum Zitat Stewart BJ, Archbold PG (1993) Nursing intervention studies require outcome measures that are sensitive to change part 2. Res Nurs Health 16(1):77–81PubMedCrossRef Stewart BJ, Archbold PG (1993) Nursing intervention studies require outcome measures that are sensitive to change part 2. Res Nurs Health 16(1):77–81PubMedCrossRef
Metadaten
Titel
Automated monitoring of symptoms during ambulatory chemotherapy and oncology providers’ use of the information: a randomized controlled clinical trial
verfasst von
Kathi H. Mooney
Susan L. Beck
Robert H. Friedman
Ramesh Farzanfar
Bob Wong
Publikationsdatum
01.09.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 9/2014
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2216-1

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