BACKGROUND: As cancer survivorship increases, health care systems will be challenged to meet patient needs. With the limited availability of clinician time and resources, novel methods of using patient-reported outcomes may improve the quality and efficiency of follow-up care in patients with breast cancer. METHODS: The authors conducted a randomized trial in patients with TNM stage I to III breast cancer comparing standard care with SIS.NET (System for Individualized Survivorship Care, based on patient self-reported data, with review by Nurse practitioners, targeted Education, and Triage), a follow-up protocol including integration of online health questionnaires at 3-month intervals and the evaluation of self-reported symptoms monitored and addressed remotely by a nurse practitioner (NP). The primary endpoint was to quantify the time between symptom reporting and remote evaluation of symptoms. The secondary endpoint was to compare use of health care resources (breast cancer-related visits, total medical appointments, and laboratory and imaging studies) over an 18-month period. RESULTS: A total of 102 participants were enrolled; 2 patients were excluded due to cancer recurrence. In the SIS.NET arm, 74% of new or changed self-reported symptoms were reviewed by a NP in <3 days. SIS.NET patients reported more new or changed symptoms compared with standard care patients (7.36 vs 3.2; P = .0045). During the 18-month trial, there were no statistically significant differences noted between the SIS.NET and standard care arms with regard to oncology-related appointments (mean, 4.2 vs 4.1 appointments), number of physician visits (mean, 10.8 vs 9.6 visits), or medical tests (mean, 5.5 vs 5 tests). CONCLUSIONS: Integration of online health questionnaires with remote review by a NP facilitated symptom reporting and may provide a means of convenient symptom assessment, but it did not appear to reduce health care resource use.
RCT Entities:
BACKGROUND: As cancer survivorship increases, health care systems will be challenged to meet patient needs. With the limited availability of clinician time and resources, novel methods of using patient-reported outcomes may improve the quality and efficiency of follow-up care in patients with breast cancer. METHODS: The authors conducted a randomized trial in patients with TNM stage I to III breast cancer comparing standard care with SIS.NET (System for Individualized Survivorship Care, based on patient self-reported data, with review by Nurse practitioners, targeted Education, and Triage), a follow-up protocol including integration of online health questionnaires at 3-month intervals and the evaluation of self-reported symptoms monitored and addressed remotely by a nurse practitioner (NP). The primary endpoint was to quantify the time between symptom reporting and remote evaluation of symptoms. The secondary endpoint was to compare use of health care resources (breast cancer-related visits, total medical appointments, and laboratory and imaging studies) over an 18-month period. RESULTS: A total of 102 participants were enrolled; 2 patients were excluded due to cancer recurrence. In the SIS.NET arm, 74% of new or changed self-reported symptoms were reviewed by a NP in <3 days. SIS.NET patients reported more new or changed symptoms compared with standard care patients (7.36 vs 3.2; P = .0045). During the 18-month trial, there were no statistically significant differences noted between the SIS.NET and standard care arms with regard to oncology-related appointments (mean, 4.2 vs 4.1 appointments), number of physician visits (mean, 10.8 vs 9.6 visits), or medical tests (mean, 5.5 vs 5 tests). CONCLUSIONS: Integration of online health questionnaires with remote review by a NP facilitated symptom reporting and may provide a means of convenient symptom assessment, but it did not appear to reduce health care resource use.
Authors: N Fridriksdottir; S Gunnarsdottir; S Zoëga; B Ingadottir; E J G Hafsteinsdottir Journal: Support Care Cancer Date: 2017-09-18 Impact factor: 3.603
Authors: Heather S L Jim; Aasha I Hoogland; Naomi C Brownstein; Anna Barata; Adam P Dicker; Hans Knoop; Brian D Gonzalez; Randa Perkins; Dana Rollison; Scott M Gilbert; Ronica Nanda; Anders Berglund; Ross Mitchell; Peter A S Johnstone Journal: CA Cancer J Clin Date: 2020-04-20 Impact factor: 508.702
Authors: Chris Gibbons; Ian Porter; Daniela C Gonçalves-Bradley; Stanimir Stoilov; Ignacio Ricci-Cabello; Elena Tsangaris; Jaheeda Gangannagaripalli; Antoinette Davey; Elizabeth J Gibbons; Anna Kotzeva; Jonathan Evans; Philip J van der Wees; Evangelos Kontopantelis; Joanne Greenhalgh; Peter Bower; Jordi Alonso; Jose M Valderas Journal: Cochrane Database Syst Rev Date: 2021-10-12
Authors: Beverley L Høeg; Pernille E Bidstrup; Randi V Karlsen; Anne Sofie Friberg; Vanna Albieri; Susanne O Dalton; Lena Saltbæk; Klaus Kaae Andersen; Trine Allerslev Horsboel; Christoffer Johansen Journal: Cochrane Database Syst Rev Date: 2019-11-21