Electronic self-report assessment for cancer: Results of a multisite randomized trial.

Abstract

9008 Background: Attending to symptoms and side effects promotes safe and effective delivery of cancer therapies. Providing focus to the patient’s report in the clinic can efficiently address the most important concerns, without extending visit times. The web-based electronic self report assessment for cancer (ESRA-C) and clinician summary has been shown to improve patient-clinician communication about symptoms and quality of life issues (SQI). The purpose of this trial was to evaluate the impact of an enhanced ESRA-C intervention (ESRA-C INT) on symptom outcomes. Methods: Patients (planned N=702) with all cancer types treated in stem cell transplant, medical oncology and radiation oncology at two comprehensive cancer centers used ESRA-C to self-report SQI during and after new anti-cancer therapy, with summary reports delivered to clinicians. Patients were randomized to standard ESRA-C (control) or ESRA-C INT adding the opportunity to self-monitor SQI between clinic visits and receive self-care SQI management education, plus custom coaching on how to report SQI to clinicians, all delivered via a secure web sites. We analyzed the intervention effect on Symptom Distress Scale (SDS) scores using a two-sided t-test and multivariate linear regression, adjusting for pre-selected covariates, including baseline SDS, age, service, and work status. Results: Among 757 patients (increased N due to involuntary attrition), demographic variables were balanced between groups except age (t=2.13; p=.03) with a younger INT group (mean 1.97 year difference). Of the 562 patients who completed final reports, the control group reported significantly higher SDS scores (t= 1.98; p = .048). A significant interaction between study group and age was observed; significantly lower SDS scores were found in the ESRA-C INT group among patients > 50 years (-1.95; p=.002), and no significant difference among patients < 50. Conclusions: Adding self-care and communication coaching to ESRA-C, a system to allow self-report and clinician notification of SQI, reduced symptom distress in a large sample of patients during and after active cancer treatment compared with ESRA-C alone. Patients over the age of 50, in particular, may benefit from the intervention.