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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Remote Symptom Monitoring With Electronic Patient-Reported Outcomes in Clinical Cancer Populations
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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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