In a randomized, controlled trial headed by a University of North Carolina Lineberger Comprehensive Cancer Center researcher, the systematic collection of cancer patients' symptoms with the use of a computer-run survey was correlated with less visits to the emergency room, longer average chemotherapy observance, as well as higher survival rates and a better quality of life.
The research, published in The Journal of Clinical Oncology, was led by Ethan Basch, MD, MSc, who is the director of the UNC Lineberger Cancer Outcomes Research Program, and is an associate professor in the UNC School of Medicine Division of Hematology and Oncology as well. In the study, cancer patients from the Memorial Sloan Kettering Cancer Center (MSKCC) in New York reported their symptoms with the use of a web-based survey system, and compared their outcomes with patients who mainly relied on usual care to be able to know their symptoms. A total of 766 patients who had metastatic cancers and were receiving outpatient chemotherapy at the MSKCC were evaluated.
In the case of the patients using the web-based survey system, nurses and doctors are able to receive automatic emails informing them if the patients are experiencing severe or worsening symptoms.
Previous researches have also shown that around half of patients' symptoms are overseen by doctors in the course of cancer treatment. This is the reason why it was recommended that survey systems such as this web-based one will be able to appropriately inform doctors about the important issues of the patients.
Basch says that if they were able to develop a drug that produced the same results, they would be very excited. This randomized trial found that integrating systematic collection of patient symptoms visa the web into cancer treatment improves multiple key clinical outcomes, he adds.
Computer Survey System
A big number of the patients involved were able to experience improvements in their quality of life, with a 34% improvement for those using the survey system, compared to only 18% improvement for those who were receiving the usual care. Those who were using the survey also had less frequent emergency room visits, with 34% still going to the ER, compared to 41% for those having usual care. They also continue with chemotherapy longer at an average of 8.2 months, compared to the other group who went only until an average of 6.3 months. Survival was also increased: 75% of patients using the system were still alive after one year, and around 69% percent for those who were accepting usual care.
I would suspect that the main mechanism of action is improved awareness by clinicians of patient symptoms, which enables earlier interventions to avert downstream, untoward events, says Basch.
The survey system, aside from giving benefits to the patients, also improved symptom management activities. It was observed that nurses were more responsive to the results of the system more than 75% of the time, and 12% of medication was changed upon receiving email alerts, as well as referrals to the ER
due to 8% of email alerts.
Similar studies are being done to see if the daily use of the survey system can actually reduce adult patients' symptoms while getting high doses of chemotherapy during bone marrow transplantation.
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