management of metastatic cancers

There has been a growing interest in integrating electronic patient-reported outcomes in the management of metastatic cancers. A group of researchers led by Dr. Basch conducted a study to determine if implementation of this system would result in improved survival rates among cancer patients.

 

The therapies available for the treatment of advanced metastatic cancers are associated with numerous side effects. Integration of an electronic patient-reported outcomes for symptom monitoring is a promising method for improving the quality of care among cancer patients. However, few studies have been done to determine the effectiveness of this strategy.

In a recent research letter published in JAMA, Doctor Ethan Basch and his colleagues conducted a follow-up of a randomized controlled trial to determine overall survival rates associated with electronic patient-reported symptom monitoring during treatment of metastatic cancers. A total of 766 patients starting chemotherapy for metastatic cancers at Memorial Sloan Kettering Cancer Center in New York between September 2007 and January 2011 participated in the controlled trial. Patients were randomly assigned to receive either electronic patient-reported outcomes (PRO) or the standard care procedure during the course of treatment. Participants included in the PRO group provided a self-report of common symptoms experienced via a web-based PRO platform. If a patient from this group reported a severe or worsening symptom, an e-mail alert was sent to the clinical nurse assigned. Those receiving the standard care procedure were routinely asked about symptoms during clinic visits, and patients contacted the clinic by telephone if they experienced any symptom in between visits. Health-related quality of life was measured in both groups 6 months after the initiation of treatment. A 1 year quality adjusted survival rate was also measured in both groups. The results of the initial trial showed that those from the PRO group reported a better quality of life and a higher 1 year quality adjusted survival rate compared to the standard treatment group.

Follow-up of the participants done in June 2016 show that 577 (67%) out of 766 had died. Median overall survival time was 31.2 months in the PRO group and 26 months in the control group. Improved survival rates in the PRO group was attributed to earlier recognition and response to patient symptoms preventing further complications. The results indicate that implementation of an electronic patient symptom monitoring system during therapy may improve clinical outcomes and quality of care received by patients with metastatic cancers.

 

Written By: Karla Sevilla

 

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