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Phase III Randomized Controlled Trial of eRAPID: eHealth Intervention During Chemotherapy
Open accessAbstract
PURPOSE: Electronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID) is an online eHealth system for patients to self-report symptoms during cancer treatment. It provides automated severity-dependent patient advice guiding self-management or medical contact and displays the reports in electronic patient records. This trial evaluated the impact of eRAPID on symptom control, healthcare use, patient self-efficacy, and quality of life (QOL) in a patient population treated predominantly with curative intent. METHODS: Patients with colorectal, breast, or gynecological cancers commencing chemotherapy were randomly assigned to usual care (UC) or the addition of eRAPID (weekly online symptom reporting for 18 weeks). Primary outcome was symptom control (Functional Assessment of Cancer Therapy-General, Physical Well-Being subscale [FACT-PWB]) assessed at 6, 12, and 18 weeks. Secondary outcomes were processes of care (admissions or chemotherapy delivery), patient self-efficacy, and global quality of life (Functional Assessment of Cancer Therapy–General, EQ5D-VAS, and EORTC QLQ-C30 summary score). Multivariable mixed-effects repeated-measures models were used for analyses. Trial registration: ISRCTN88520246. RESULTS: Participants were 508 consenting patients (73.6% of 690 eligible) and 55 health professionals. eRAPID compared to UC showed improved physical well-being at 6 ( P = .028) and 12 ( P = .039) weeks and no difference at 18 weeks (primary end point) ( P = .69). Fewer eRAPID patients (47%) had clinically meaningful physical well-being deterioration than UC (56%) at 12 weeks. Subgroup analysis found benefit in the nonmetastatic group at 6 weeks ( P = .0426), but not in metastatic disease. There were no differences for admissions or chemotherapy delivery. At 18 weeks, patients using eRAPID reported better self-efficacy ( P = .007) and better health on EQ5D-VAS ( P = .009). Average patient compliance with weekly symptom reporting was 64.7%. Patient adherence was associated with clinician's data use and improved FACT-PWB at 12 weeks. CONCLUSION: Real-time monitoring with electronic patient-reported outcomes improved physical well-being (6 and 12 weeks) and self-efficacy (18 weeks) in a patient population predominantly treated with curative intent, without increasing hospital workload.
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“Phase III evidence from the eRAPID program has further established the value of ePRO integration in routine chemotherapy care [7].”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [7]
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“which have demonstrated improved symptom control, quality of life, and survival when structured symptom reporting is coupled with clinician response [3,4,7]”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [7]
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“While eRAPID [7] and PRO-CTCAE [14] have demonstrated efficacy in longitudinal symptom tracking and research contexts”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [7]
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“The findings of this evaluation are consistent with prior trials of ePRO monitoring”
From Implementing UK Oncology Nursing Society–Informed Digital Symptom Triage With Episode-Based Review in Routine NHS Acute Oncology: Service Evaluation (2026) · cites this paper as [7]
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Metadata
- Authors
- Absolom, K., Warrington, L., Hudson, E., Hewison, J., Morris, C., Holch, P., Carter, R., Gibson, A., Holmes, M., Clayton, B., Rogers, Z., McParland, L., Conner, M., Glidewell, L., Woroncow, B., Dawkins, B., Dickinson, S., Hulme, C., Brown, J., & Velikova, G.
- Affiliations
- University of Leeds (GB)
- Patient Representative, Independent Cancer Patients Voices, Brighton, United Kingdom
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2021-03-01
- Volume
- 39
- Issue
- 7
- Pages
- 734-747
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W3118788544
- Cited by
- 311
- References
- 37
- Citations by year
- 2026: 49 · 2025: 60 · 2024: 59 · 2023: 50 · 2022: 59 · 2021: 34
- FWCI
- 18.38
- Type
- journal article
- Language
- en
- Open access
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Open Research Exeter (University of Exeter) (acceptedVersion)
- Figshare (submittedVersion)
- Funders
- Pfizer
- National Institute for Health and Care Research (RP-PG-0611-20008, RP-DG-1209-10031)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Keywords
- digital health interventions, chemotherapy side effects, symptom management, physical well-being, patient self-efficacy, quality of life, health care utilization, real-time symptom monitoring, colorectal cancer, breast cancer, gynecologic cancer, patient adherence, electronic health records, EQ-5D
- MeSH terms
- Patient Reported Outcome Measures, Adolescent, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, England, Female, Hospitalization, Humans, Male, Middle Aged, Neoplasms, Prospective Studies, Quality of Life, Therapy, Computer-Assisted, Time Factors, Treatment Outcome, Telemedicine, Self Efficacy, Young Adult, Electronic Health Records, Symptom Assessment
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