Symptoms are common among patients receiving treatment for advanced cancers, yet are undetected by clinicians up to half the time. There is growing interest in integrating electronic patient-reported outcomes (PROs) into routine oncology practice for symptom monitoring, but evidence demonstrating clinical benefit has been limited. Ethan Basch, M.D., of the Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, and Associate Editor, JAMA, and colleagues assessed overall survival associated with electronic patient-reported symptom monitoring vs usual care based on follow-up from a randomized clinical trial.
Patients initiating routine chemotherapy for metastatic solid tumors at Memorial Sloan Kettering Cancer Center in New York between September 2007 and January 2011 were invited to participate in the trial; participants were randomly assigned either to the usual care group or to the PRO group, in which patients provided self-report of 12 common symptoms at and between visits via a web-based PRO questionnaire platform. When the PRO group participants reported a severe or worsening symptom, an email alert was triggered to a clinical nurse responsible for the care of that patient. A report profiling each participant’s symptom burden history was generated at clinic visits for the treating oncologist.
Dr. Stegall’s Comments: Streamlining communication between patients and their doctors is essential. Unfortunately, in practice, this is difficult to do. A typical day for an oncologist includes seeing patients, charting, reviewing labs, and returning phone calls. We frequently feel pulled in multiple directions, which is why having a great team is so important. If we can use electronics to improve the efficiency and quality of this communication, I am all for it.