Cited by 2,593Cancer survivorship and careMobile Health and mHealth ApplicationsPain Management and Opioid Use

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Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

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Basch, Ethan, Deal, Allison M., Kris, Mark G., Scher, Howard I., Hudis, Clifford A., Sabbatini, Paul, Rogak, Lauren, Bennett, Antonia V., Dueck, Amylou C., Atkinson, Thomas M., Chou, Joanne F., Dulko, Dorothy, Sit, Laura, Barz, Allison, Novotny, Paul, Fruscione, Michael, Sloan, Jeff A., Schrag, Deborah·2016·Journal of Clinical Oncology

DOI 10.1200/jco.2015.63.0830PMC PMC4872028

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Abstract

Purpose: There is growing interest to enhance symptom monitoring during routine cancer care using patient-reported outcomes, but evidence of impact on clinical outcomes is limited. Methods: We randomly assigned patients receiving routine outpatient chemotherapy for advanced solid tumors at Memorial Sloan Kettering Cancer Center to report 12 common symptoms via tablet computers or to receive usual care consisting of symptom monitoring at the discretion of clinicians. Those with home computers received weekly e-mail prompts to report between visits. Treating physicians received symptom printouts at visits, and nurses received e-mail alerts when participants reported severe or worsening symptoms. The primary outcome was change in health-related quality of life (HRQL) at 6 months compared with baseline, measured by the EuroQol EQ-5D Index. Secondary endpoints included emergency room (ER) visits, hospitalizations, and survival. Results: Among 766 patients allocated, HRQL improved among more participants in the intervention group than usual care (34% v 18%) and worsened among fewer (38% v 53%; P < .001). Overall, mean HRQL declined by less in the intervention group than usual care (1.4- v 7.1-point drop; P < .001). Patients receiving intervention were less frequently admitted to the ER (34% v 41%; P = .02) or hospitalized (45% v 49%; P = .08) and remained on chemotherapy longer (mean, 8.2 v 6.3 months; P = .002). Although 75% of the intervention group was alive at 1 year, 69% with usual care survived the year (P = .05), with differences also seen in quality-adjusted survival (mean of 8.7 v. 8.0 months; P = .004). Benefits were greater for participants lacking prior computer experience. Most patients receiving intervention (63%) reported severe symptoms during the study. Nurses frequently initiated clinical actions in response to e-mail alerts. Conclusion: Clinical benefits were associated with symptom self-reporting during cancer care.

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Self-citation
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Influential
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BackgroundMethod
Development of an eHealth Tool for Capturing and Analyzing the Immune-related Adverse Events (irAEs) in Cancer Treatment
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Background
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Background
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Kaur, G., Kyte, D. G., Reeve, B. B., Basch, E., & Calvert, M. (2019) · The Lancet Oncology · doi:10.1016/s1470-2045(18)30785-x · Cited by 13
Self-citation
What symptoms are important to patients? Developing a symptom burden measure for women with breast cancer
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BackgroundSelf-citation
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BackgroundMethodInfluential
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“This corresponds with previous studies, in which symptom selfreporting during cancer treatment was associated with clinical benefits and increased survival [13, 38].”
Result
Association Between Health-Related Quality of Life and Progression-Free Survival in Patients With Advanced Cancer: A Secondary Analysis of SWOG Clinical Trials
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Background
Development and consensus process for a clinical pathway for the assessment and management of chemotherapy-induced peripheral neuropathy
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“Resource Utilization Seven trials involving 17 216 patients assessed resource utilization,(14,17,19,20,25,31,37) 3 of them reported a considerable reduction in tele-palliative care recipients’ utilization.(17,20,37) Seven trials looked at hospital utilization, 3 of 5 trials with a low risk of bias found statistically…”
Influential
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“Patient-reported symptom monitoring has already proven to be feasible and effective in oncology practice, improving early detection andmanagement of adverse events (AEs), quality of life (QoL), and even overall survival.(20,21) Adequate acute toxicity monitoring in CAR T-cell therapy includes a triplet of daily sympto…”
Background
Selecting a PRO-CTCAE-based subset for patient-reported symptom monitoring in prostate cancer patients: a modified Delphi procedure
Feldman, E., Pos, F. J., Smeenk, R. J., van der Poel, H. G., van Leeuwen, P., de Feijter, J. M., Hulshof, M. C. C. M., Budiharto, T., Hermens, R., de Ligt, K. M., et al. (2023) · ESMO Open · doi:10.1016/j.esmoop.2022.100775 · Cited by 13
The Subjective Will and Psychological Experience of Home-Based Exercise in Lung Cancer Patients During Interval of Chemotherapy: A Qualitative Study
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“A regular follow-up plan led by the nursing team can be formulated, and patients’ disease symptoms and functional status can be given continuous attention and guidance with the help of patient-reported outcome measurement tools as the carrier of mobile health.(35,36) The home exercise guidance plan can be adjusted thr…”
Background
Monitoring of rest-activity rhythm in cancer patients paves the way for the adoption of patient-specific chronotherapeutic approach
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Pilot Testing a Web-Based System for the Assessment and Management of Chemotherapy-Induced Peripheral Neuropathy
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Racial disparity in oncologic and quality‐of‐life outcomes in patients with locally advanced head and neck squamous cell carcinomas enrolled in a randomized phase 2 trial
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Treatment data and technical process challenges for practical big data efforts in radiation oncology
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Preventing Chemotherapy-Induced Nausea and Vomiting with Netupitant/Palonosetron, the First Fixed Combination Antiemetic: Current and Future Perspective
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Application of quality control circle in the treatment of moderate cancer pain in inpatients
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The potential use for patient reported outcome measures in people with pancreatic cancer, with a specific focus on older patients
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Age Is Not a Barrier: Older Adults With Cancer Derive Similar Benefit in a Randomized Controlled Trial of a Remote Symptom Monitoring Intervention Compared With Younger Adults
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Screening for Financial Toxicity in Clinical Care With Finance-Related Outcome Measures
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The Head and Neck Survivorship Tool (HN-STAR) Trial (WF-1805CD): A protocol for a cluster-randomized, hybrid effectiveness-implementation, pragmatic trial to improve the follow-up care of head and neck cancer survivors
Salz, T., Ostroff, J. S., Nightingale, C. L., Atkinson, T. M., Davidson, E. C., Jinna, S., Kriplani, A., Lesser, G. J., Lynch, K. A., Mayer, D. K., et al. (2021) · Contemporary Clinical Trials · doi:10.1016/j.cct.2021.106448 · Cited by 12
Self-citation
Race Differences in Patient-Reported Symptoms during Chemotherapy among Women with Early-Stage Hormone Receptor–Positive Breast Cancer
Hu, X. Y., Kaplan, C. M., Martin, M. Y., Walker, M. S., Stepanski, E. J., Schwartzberg, L. S., Vidal, G. A., & Graetz, I. (2022) · Cancer Epidemiology Biomarkers & Prevention · doi:10.1158/1055-9965.epi-22-0692 · Cited by 13
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Self-citation
A randomized controlled trial using surgical gloves to prevent chemotherapy-induced peripheral neuropathy by paclitaxel in breast cancer patients (AIUR trial)
Kang, Y.-J., Yoon, C. I., Yang, Y.-J., Baek, J. M., Kim, Y., Jeon, Y. W., Rhu, J., Yi, J. P., Kim, D., & Oh, S. J. (2023) · BMC Cancer · doi:10.1186/s12885-023-11079-8 · Cited by 13
“Besides, enhanced survival has been linked to patient-reported symptom monitoring in patients with metastatic cancer [25, 26].”
Background
Pancreatic Cancer Surgery: What Matters to Patients?
Martin, D. J., Alberti, P., Wigmore, S. J., Demartines, N., & Joliat, G. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12144611 · Cited by 12
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Background
Global Perceptions on ERAS® in Pancreatoduodenectomy
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“PROM integration in clinical practice not only improves communication between patient and clinician, quality of care, patient experience, but has been associated with reduced emergency department visits and improved oncologic outcomes [38, 39].”
Background
Feasibility and User Experience of Digital Patient Monitoring for Real-World Patients With Lung or Breast Cancer
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Real-world use and clinical impact of an electronic patient-reported outcome tool in patients with solid tumors treated with immuno-oncology therapy
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A review of the use of machine learning in predictive analytics for patient health outcomes in pharmacy practice
Adeghe, E. P., Okolo, C. A., & Ojeyinka, O. T. (2024) · Open Access Research Journal of Life Sciences · doi:10.53022/oarjls.2024.7.1.0026 · Cited by 15
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A randomized trial of the impact of symptom monitoring using an electronic patient-reported outcome app on health-related quality of life in postmenopausal breast cancer patients receiving adjuvant endocrine therapy
Okuyama, H., Takada, F., Taira, N., & Nakamura, S. (2024) · Breast Cancer · doi:10.1007/s12282-024-01592-4 · Cited by 14
“In a post hoc analysis, the median survival period was 31.2 months in the STAR group and 26.0 months for patients receiving standard care, indicating significantly improved OS in the STAR group [16].”
Influential
Barriers and facilitators to the uptake of electronic collection and use of patient-reported measures in routine care of older adults: a systematic review with qualitative evidence synthesis
Senarath, G. H., Haghighi, P. D., Bai, L., Shannon, M., Andrew, N. E., Srikanth, V. K., Snowdon, D. A., & O’Connor, D. A. (2024) · JAMIA Open · doi:10.1093/jamiaopen/ooae068 · Cited by 16
Can Digital Health Improve Therapeutic Compliance in Oncology?
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Electronic Patient-Reported Outcome System Implementation in Outpatient Cardiovascular Care
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Patient reported outcomes in evaluation of chemotherapy toxicity in women with gynecologic malignancies: A pilot study
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QOL Evaluation of Nab-Paclitaxel and Docetaxel for Early Breast Cancer
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Implementation of a Brief Screening Tool to Identify Needs of Breast Cancer Survivors
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Assessing the Desmoid-Type Fibromatosis Patients’ Voice: Comparison of Health-Related Quality of Life Experiences from Patients of Two Countries
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Biometric Monitoring Technologies in Cancer: The Past, Present, and Future
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Background
A novel smartphone application for the informal caregivers of cancer patients: Usability study
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Self-citation
The Potential Role of Symptom Questionnaires in Palliative and Supportive Cancer Care Delivery
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Implementation and first results of a tablet-based assessment referring to patient-reported outcomes in an inpatient cancer care unit
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Authors: Basch, E., Deal, A. M., Kris, M. G., Scher, H. I., Hudis, C. A., Sabbatini, P., Rogak, L., Bennett, A. V., Dueck, A. C., Atkinson, T. M., Chou, J. F., Dulko, D., Sit, L., Barz, A., Novotny, P., Fruscione, M., Sloan, J. A., & Schrag, D.
Affiliations: University of North Carolina at Chapel Hill (US)
Ethan Basch, Mark G. Kris, Howard I. Scher, Clifford A. Hudis, Paul Sabbatini, Lauren Rogak, Thomas M. Atkinson, Joanne F. Chou, Dorothy Dulko, Laura Sit, Michael Fruscione, and Deborah Schrag, Memorial Sloan Kettering Cancer Center, New York, NY; Ethan Basch, Allison M. Deal, and Antonia V. Bennett, University of North Carolina, Chapel Hill, NC; Amylou C. Dueck, Mayo Clinic, Scottsdale, AZ; Allison Barz, Children’s Hospital of Philadelphia, Philadelphia, PA; Paul Novotny and Jeff A. Sloan, Mayo Clinic,...
ORCID: Basch, Ethan
Deal, Allison M.
Kris, Mark G.
Scher, Howard I.
Hudis, Clifford A.
Sabbatini, Paul
Rogak, Lauren
Bennett, Antonia V.
Dueck, Amylou C.
Atkinson, Thomas M.
Chou, Joanne F.
Dulko, Dorothy
Sit, Laura
Novotny, Paul
Fruscione, Michael
Sloan, Jeff A.
Schrag, Deborah
Venue: Journal of Clinical Oncology
Publisher: American Society of Clinical Oncology (ASCO)
Published: 2016-02-20
Volume: 34
Issue: 6
Pages: 557-565
ISSN: 0732-183X (ISSN-L)
1527-7755
DOI: 10.1200/jco.2015.63.0830
PMC: PMC4872028
OpenAlex: W2195040438
Cited by: 2,593
References: 36
Citations by year: 2026: 252 · 2025: 263 · 2024: 321 · 2023: 288 · 2022: 316 · 2021: 299 · 2020: 292 · 2019: 191 · 2018: 180 · 2017: 143 · 2016: 44
FWCI: 53.87
Type: journal article
Language: en
Update notices: correction (2019-02-07)
correction (2016-06-20)
Open access: green
www.ncbi.nlm.nih.gov
Locations: Journal of Clinical Oncology (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Memorial Sloan-Kettering Cancer Center
Society of Memorial Sloan Kettering
National Cancer Institute (P30CA008748, P30CA015083, P30CA016086)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords: patient-reported outcomes, symptom monitoring, cancer chemotherapy, health-related quality of life, advanced solid tumors, e-mail alerts, emergency department visits, hospitalization, survival, quality-adjusted survival, computer literacy, outpatient oncology
MeSH terms: Adult, Aged, Aged, 80 and over, Ambulatory Care, Antineoplastic Agents, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Middle Aged, Neoplasms, Quality of Life, Survival Rate, Internet, Nurse's Role, Electronic Mail, Self Report, Symptom Assessment

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Symptom Monitoring With Patient-Reported Outcomes During Routine Cancer Treatment: A Randomized Controlled Trial

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