Telemonitoring of symptoms among patients with advanced cancer undergoing treatment can significantly improve their quality of life while reducing the number of doctor visits and hospitalizations. Overall patient survival was not affected in any way by remote symptom monitoring. The results come from the PRO-TECT study, presented at the annual meeting of the European Society of Medical Oncology, ESMO 2023.
By completing a weekly online or telephone questionnaire, a system called ePRO (electronic patient-reported outcomes), patients were able to keep in touch with the medical team more easily. In addition to information related to performance status, the ePRO system also included questions about 9 of the most common symptoms. If patients report severe symptoms or worsening symptoms, the system notifies the medical team in real time via the patients’ electronic files or directly by email.
While there are many advantages (cost-effectiveness, accessibility in rural or underserved areas, improved communication) to implementing a telemonitoring system for symptoms of patients undergoing treatment for advanced cancer, the associated challenges must also be considered. Among them are the adaptability of doctors and patients to new technologies, the way of communicating data so that it can benefit as many patients as possible (by phone, online, etc.), data security and so on.
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During the treatment of patients with advanced cancer, symptoms such as fatigue, malaise or vomiting are very common. If such symptoms can easily be missed during routine medical visits, remote monitoring of the patient’s condition helps the team of specialists to detect them early, being able to intervene as promptly as possible. According to the patients enrolled in the study, such a telemonitoring system is very useful, helping them feel in control of their therapeutic course.
The PRO-TECT trial included approximately 1,200 cancer patients, randomly assigned to a control group, in which participants received routine medical care, and a study group, in which, in addition to routine care, ePRO questionnaires were introduced. All people with advanced cancer were included, except for patients with indolent lymphoma and acute leukemia receiving systemic treatment.
“Evidence shows that we as clinicians can miss up to 50% of our patients’ symptoms, which could lead to serious consequences. Even though in this study survival was not influenced, patients consider the intervention to be of value, experiencing an improved quality of life and a lower hospitalization rate” – says Dr. Ethan BaschUniversity of North Carolina Lineberg Comprehensive Cancer Center, Chapel Hill.
In total, patients completed more than 91% of the electronic questionnaires. So no significant differences were observed in overall survival (42.0 months in the ePRO group and 43.5 months in the control group), a 6% reduction in hospitalization rate was observed. Also, at one year, it took longer until the first hospitalization was recorded among patients who used the ePRO questionnaires compared to patients in the control group.
As with advanced cancer patients, who viewed the use of a remote symptom monitoring system in a positive light, so did most of the nurses involved in the study. They considered the information submitted by patients to be useful in documenting electronic medical records, while also improving doctor-patient communication. A quarter of the assistants involved are reluctant to continue using the telemonitoring system because of the added workload.
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2023-11-14 09:08:02
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