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Patients on chemotherapy for advanced cancer who reported 12 symptoms weekly through a web tool, with nurse alerts for severe symptoms, lived a median 5 months longer than those receiving usual care.
This single-centre trial at Memorial Sloan Kettering randomised 766 patients starting chemotherapy for metastatic solid tumours to weekly electronic self-reporting of 12 common symptoms (with email alerts to nurses when symptoms worsened or were severe) or to usual care, in which symptoms were discussed at visits.
The 2016 JCO report showed better health-related quality of life at 6 months (improved in 34% vs 18%), fewer emergency department visits (34% vs 41%), fewer hospitalisations and longer time on chemotherapy (8.2 vs 6.3 months). This 2017 research letter reported the overall survival analysis: median 31.2 months with self-reporting versus 26.0 months with usual care.
The survival result, replicated in a French lung cancer trial (Denis, JAMA 2019), turned symptom monitoring into a standard of care and drove the design of the multi-site PRO-TECT trial.
Routinely asking patients how they feel between visits, and acting on the answers, is a treatment in itself. It catches problems early, keeps people on effective therapy longer and appears to extend life. Cancer centres now build symptom monitoring into electronic records, though implementation is uneven.
Shares Electronic patient-reported outcomes and remote monitoring, Electronic patient-reported outcome (ePRO) symptom monitoring.
Shares Electronic patient-reported outcomes and remote monitoring, Electronic patient-reported outcome (ePRO) symptom monitoring.
Shares Electronic patient-reported outcomes and remote monitoring, Electronic patient-reported outcome (ePRO) symptom monitoring.
Shares Ethan Basch, Patients lack understanding, navigation and agency, Toxicity and quality of life are undervalued.
Shares Electronic patient-reported outcome (ePRO) symptom monitoring, JAMA.
Shares Patient-reported symptoms captured as standard structured data in every clinic, Toxicity and quality of life are undervalued.
Shares Electronic patient-reported outcome (ePRO) symptom monitoring, Patients lack understanding, navigation and agency, Fragmented care and guideline gaps, Memorial Sloan Kettering Cancer Center.
Shares Patients lack understanding, navigation and agency, Memorial Sloan Kettering Cancer Center, Toxicity and quality of life are undervalued.