Abstract
PurposeTo evaluate the feasibility of implementing systematic patient symptom monitoring during treatment using a smartphone.MethodsEndometrial [n = 50], ovarian [n = 70] and breast [n = 193] cancer patients participated in text-based symptom reporting for up to 12 months. In order to promote equity, patients without a smartphone were provided with a device, with the phone charges paid by program funds. Each month, patients completed the Patient Health Questionnaire (PHQ-9), and 4 single items assessing fatigue, sleep quality, pain, and global quality of life during the past 7 days rated on a 0 (low) –10 (high) scale. Patients’ responses were captured using REDCap, with oncologists receiving monthly feedback. Lay navigators provided assistance to patients with non-medical needs.ResultsPatients utilizing this voluntary program had an overall mean age of 60.5 (range 26–87), and 85% were non-Hispanic white. iPhones were provided to 42 patients, and navigation services were used by 69 patients. Average adherence with monthly surveys ranged between 75–77%, with breast patients having lower adherence after 5 months. The most commonly reported symptoms across cancer types were moderate levels (scores of 4–7) of fatigue and sleep disturbance. At 6 months, 71–77% of all patients believed the surveys were useful to them and their health care team.ConclusionsWe established the feasibility of initiating and managing patients in a monthly text-based symptom-monitoring program. The provision of smartphones and patient navigation were unique and vital components of this program.
Highlights
Symptom management utilizing patient-reported outcomes is an important area of focus in cancer care [1]
In Gynecologic Oncology, post-operative ovarian and endometrial patients were identified by program staff using the electronic health record (EHR) EPIC
This paper reported on the feasibility of implementing text-based symptom monitoring with patient navigation to assist ovarian, endometrial, and breast cancer patients undergoing treatment
Summary
Symptom management utilizing patient-reported outcomes is an important area of focus in cancer care [1]. The use of patient-reported outcome (PRO) measures during cancer treatment has been shown to improve patients’ survival rates and result in fewer emergency department (ED) visits and hospitalizations, and less symptom burden during hospital stays [10, 11]. When patients have their symptoms addressed or at least relayed to their physicians, it has been found to improve patient satisfaction with care [12], and can help reduce patient anxiety and promote self-care [13]. The a priori goals for program success were that (1) ≥ 85% of patients approached would participate in the monitoring program; and (2) adherence to the surveys during the 12-month period would be ≥ 75% for all cancer types
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