Ethan Basch1, Allison M Deal2, Mark G Kris2, Howard I Scher2, Clifford A Hudis2, Paul Sabbatini2, Lauren Rogak2, Antonia V Bennett2, Amylou C Dueck2, Thomas M Atkinson2, Joanne F Chou2, Dorothy Dulko2, Laura Sit2, Allison Barz2, Paul Novotny2, Michael Fruscione2, Jeff A Sloan2, Deborah Schrag2. 1. 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, Rochester, MN; and Deborah Schrag, Dana-Farber/Harvard Cancer Center, Boston, MA. ebasch@med.unc.edu. 2. 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, Rochester, MN; and Deborah Schrag, Dana-Farber/Harvard Cancer Center, Boston, MA.
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.
RCT Entities:
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.
Authors: Donna L Berry; Brent A Blumenstein; Barbara Halpenny; Seth Wolpin; Jesse R Fann; Mary Austin-Seymour; Nigel Bush; Bryant T Karras; William B Lober; Ruth McCorkle Journal: J Clin Oncol Date: 2011-01-31 Impact factor: 44.544
Authors: Thomas M Atkinson; Yuelin Li; Charles W Coffey; Laura Sit; Mary Shaw; Dawn Lavene; Antonia V Bennett; Mike Fruscione; Lauren Rogak; Jennifer Hay; Mithat Gönen; Deborah Schrag; Ethan Basch Journal: Qual Life Res Date: 2011-10-08 Impact factor: 4.147
Authors: Michael J Fisch; Ju-Whei Lee; Matthias Weiss; Lynne I Wagner; Victor T Chang; David Cella; Judith B Manola; Lori M Minasian; Worta McCaskill-Stevens; Tito R Mendoza; Charles S Cleeland Journal: J Clin Oncol Date: 2012-04-16 Impact factor: 44.544
Authors: Claire F Snyder; Neil K Aaronson; Ali K Choucair; Thomas E Elliott; Joanne Greenhalgh; Michele Y Halyard; Rachel Hess; Deborah M Miller; Bryce B Reeve; Maria Santana Journal: Qual Life Res Date: 2011-11-03 Impact factor: 4.147
Authors: Marija Trajkovic-Vidakovic; Alexander de Graeff; Emile E Voest; Saskia C C M Teunissen Journal: Crit Rev Oncol Hematol Date: 2012-03-31 Impact factor: 6.312
Authors: Ethan Basch; Amy P Abernethy; C Daniel Mullins; Bryce B Reeve; Mary Lou Smith; Stephen Joel Coons; Jeff Sloan; Keith Wenzel; Cynthia Chauhan; Wayland Eppard; Elizabeth S Frank; Joseph Lipscomb; Stephen A Raymond; Merianne Spencer; Sean Tunis Journal: J Clin Oncol Date: 2012-10-15 Impact factor: 44.544
Authors: Stephanie L Pugh; Joseph P Rodgers; Katherine A Yeager; Ronald C Chen; Benjamin Movsas; Roseann Bonanni; James Dignam; Deborah W Bruner Journal: Int J Radiat Oncol Biol Phys Date: 2020-06-24 Impact factor: 7.038
Authors: R D Nipp; A El-Jawahri; M Ruddy; C Fuh; B Temel; S M D'Arpino; B J Cashavelly; V A Jackson; D P Ryan; E P Hochberg; J A Greer; J S Temel Journal: Ann Oncol Date: 2019-02-01 Impact factor: 32.976
Authors: Mark A Ellis; Katherine R Sterba; Terry A Day; Courtney H Marsh; Stacy Maurer; Elizabeth G Hill; Evan M Graboyes Journal: Otolaryngol Head Neck Surg Date: 2019-04-09 Impact factor: 3.497
Authors: Goldy C George; Tito R Mendoza; Eucharia C Iwuanyanwu; Meryna Manandhar; Solmaz F Afshar; Sarina A Piha-Paul; Apostolia Tsimberidou; Aung Naing; Charles S Cleeland; David S Hong Journal: Invest New Drugs Date: 2019-11-25 Impact factor: 3.850
Authors: Jennifer E Flythe; Tandrea Hilliard; Elena Lumby; Graciela Castillo; Jazmine Orazi; Emaad M Abdel-Rahman; Amy Barton Pai; Matthew Bertrand Rivara; Wendy L St Peter; Steven Darrow Weisbord; Caroline M Wilkie; Rajnish Mehrotra Journal: Clin J Am Soc Nephrol Date: 2018-11-05 Impact factor: 8.237
Authors: Bobby Daly; Gilad Kuperman; Alice Zervoudakis; Abigail Baldwin Medsker; Ankita Roy; Alice S Ro; Javiera Arenas; Hrudaya Veena Yanamandala; Raj Kottamasu; Rori Salvaggio; Jessie Holland; Stephanie Hirsch; Chasity B Walters; Tara Lauria; Kim Chow; Aaron Begue; Margarita Rozenshteyn; Melissa Zablocki; Amandeep K Dhami; Nicholas Silva; Emily Brown; Lauren L Katzen; Yeneat O Chiu; Claire Perry; Stefania Sokolowski; Isaac Wagner; Stephen R Veach; Rachel N Grisham; Chau T Dang; Diane L Reidy-Lagunes; Brett A Simon; Wendy Perchick Journal: JCO Oncol Pract Date: 2020-05-29
Authors: Christopher R Friese; Alex J Fauer; Clare Kuisell; Kari Mendelsohn-Victor; Nathan C Wright; Jennifer J Griggs; Milisa Manojlovich Journal: Health Serv Res Date: 2020-10-30 Impact factor: 3.402