The assessment and management of chemotherapy-related toxicities in patients with breast cancer, colorectal cancer, and Hodgkin's and non-Hodgkin's lymphomas: A scoping review (original) (raw)
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Supportive Care in Cancer, 2008
Objectives: To evaluate the impact of a mobile phone based, remote monitoring, advanced symptom management system (ASyMS ©) on the incidence, severity and distress of six chemotherapy related symptoms (nausea, vomiting, fatigue, mucositis, hand foot syndrome, diarrhoea) in patients with lung, breast or colorectal cancer. Design: A two group (intervention and control), by 5 time points (baseline, precycle 2, pre-cycle 3, pre-cycle 4 and pre-cycle 5) randomised controlled trial. Setting: Seven clinical sites in the UK; 5 specialist cancer centres and 2 local district hospitals. Participants: One hundred and twelve people with breast, lung or colorectal cancer receiving out patient chemotherapy. Interventions: A mobile, phone based remote monitoring advanced symptom management system (ASyMS ©). Main outcome measures: Chemotherapy related morbidity of six common chemotherapy related symptoms (nausea, vomiting, fatigue, mucositis, hand foot syndrome and diarhhoea) Results: There were significantly higher reports of fatigue in the control group compared to the intervention group (odds ratio 2.29, 95% CI 1.04 to 5.05, P=0.040) and reports of hand foot syndrome were on average lower in the control group (odds ratio control: intervention, 0.39, 95% CI to 0.92, P=0.031). 4 Conclusion: The study demonstrates that ASyMS © can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy. Trial registration ISRCTN 67370244
2018
Background: ASyMS is a mobile‐phone based remote‐monitoring and alert system that enables real‐time monitoring of patients' chemotherapy (CT)–related symptoms. Aims: eSMART aims to evaluate the short‐ and long‐term impact of ASyMS, compared with standard care, on patient reported outcomes and the delivery of care. Additionally, eSMART includes economic evaluation and the development of predictive risk models for experiencing CT‐related symptoms to enable personalised and anticipatory care. Methods: Patients newly diagnosed with breast, haematological, or colorectal cancer and scheduled to receive at least 3 cycles of chemotherapy are recruited across 5 countries and 13 clinical sites. A total of 1108 patients will be randomised to either ASyMS or standard care. Patient demographic and clinical data are collected at baseline, and standardised PROMS are completed at baseline, during 6 cycles of chemotherapy and every 3 months for up to 12 months. The primary outcome measure is the...
Application of mobile phone technology for managing chemotherapy-associated side-effects
Annals of Oncology, 2007
Background: Novel mobile phone technology linked to a server that communicates patients' symptoms to healthcare professionals has been adapted to register the side-effects of chemotherapy and provide advice on management of toxicity. We report a feasibility study to examine the utility of home monitoring of patients' symptoms via a mobile phone. Methods: Six colon cancer patients receiving adjuvant chemotherapy, entered symptom data onto user friendly screens on a mobile phone twice daily. This 'real time' self assessment of nausea, vomiting, mucositis, diarrhoea and hand-foot syndrome and measurement of temperature was sent via a secured connection to a remote computer. In the event of moderate or severe symptoms (generating amber and red alerts respectively), the nurse was immediately alerted by the computer, via a pager. The nurse then contacted the patient to reinforce the automatic advice sent to the patient on their phone and to assess the patient using clinical algorithms. Results: The patient used the mobile phones during the first two cycles of chemotherapy. The data were successfully analysed by the server software and alerts were generated alerting the study nurses to patients' symptoms at the appropriate time. There were 91 alerts-54 red and 37 amber; 54% (29/54) of the red alerts were data delay and transmission problems which were swiftly rectified. The remaining red alerts were managed appropriately by the study nurses. Both patients and staff felt confident in this approach to symptom management. Conclusions: This study demonstrates that the technology for monitoring patients' symptoms worked well. The patients felt secure in the knowledge that their symptoms were being closely monitored and that they were participating effectively in their own care management.
2021
Background To establish the evidence related to the efficacy of mobile phone technology for managing side effects of chemotherapy and improved quality of life among patients with cancer. Methods Articles published in peer-reviewed journals were included in this review. Randomized control trials (RCTs) and non-randomized control trials (non-RCTs) consisting of mobile-based interventions (mobile application, smart phone App-based interventions or guidelines to manage side-effects of chemotherapy or mobile health services), and adult cancer patients (aged 18 or above years) as participants who were undergoing chemotherapy and received mobile phone-based interventions as an interventional group versus control/comparator group who were getting routine or usual care were included in this systematic review. Databases such as Scopus, Science Direct, Cochrane library, PubMed, and Google Scholar were systematically searched between 2007 and 2020. Using the Cochrane risk of bias tool, the methodological quality of the included studies was evaluated by two independent authors. Results We included 10 trials, involving 1467 cancer patients and the number of participants ranged from 50 to 457. All trials measured the side effects of chemotherapy as the main outcome and three trials measured the quality of life as the main outcome. Ten trials included for narrative synthesis showed a significant decrease in chemotherapy side effects and considerable improvement in the quality of life in the interventional group than in the comparison group. Meta-analysis of four RCTs containing 803 subjects concluded a significant improvement (p < 0.0001) in the quality of life.
BMJ open, 2017
While some evidence exists that real-time remote symptom monitoring devices can decrease morbidity and prevent unplanned admissions in oncology patients, overall, these studies have significant methodological weaknesses. The electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology (eSMART) study is designed to specifically address these weaknesses with an appropriately powered, repeated-measures, parallel-group stratified randomised controlled trial of oncology patients. A total of 1108 patients scheduled to commence first-line chemotherapy (CTX) for breast, colorectal or haematological cancer will be recruited from multiple sites across five European countries.Patients will be randomised (1:1) to the ASyMS intervention (intervention group) or to standard care currently available at each site (control group). Patients in the control and intervention groups will complete a demographic and clinical questionnaire, as well as a set of valid an...
JMIR Cancer
Background: There has been an international shift in health care, which has seen an increasing focus and development of technological and personalized at-home interventions that aim to improve health outcomes and patient-clinician communication. However, there is a notable lack of empirical evidence describing the preparatory steps of adapting and implementing technology of this kind across multiple countries and clinical settings. Objective: This study aimed to describe the steps undertaken in the preparation of a multinational, multicenter randomized controlled trial (RCT) to test a mobile phone-based remote symptom monitoring system, that is, Advanced Symptom Management System (ASyMS), designed to enhance management of chemotherapy toxicities among people with cancer receiving adjuvant chemotherapy versus standard cancer center care. Methods: There were 13 cancer centers across 5 European countries (Austria, Greece, Ireland, Norway, and the United Kingdom). Multiple steps were undertaken, including a scoping review of empirical literature and clinical guidelines, translation and linguistic validation of study materials, development of standardized international care procedures, and the integration and evaluation of the technology within each cancer center. Results: The ASyMS was successfully implemented and deployed in clinical practices across 5 European countries. The rigorous and simultaneous steps undertaken by the research team highlighted the strengths of the system in clinical practice, as well as the clinical and technical changes required to meet the diverse needs of its intended users within each country, before the commencement of the RCT.
Mobile Phone Based System Opportunities to Home-based Managing of Chemotherapy Side Effects
Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : časopis Društva za medicinsku informatiku BiH, 2016
Applying mobile base systems in cancer care especially in chemotherapy management have remarkable growing in recent decades. Because chemotherapy side effects have significant influences on patient's lives, therefore it is necessary to take ways to control them. This research has studied some experiences of using mobile phone based systems to home-based monitor of chemotherapy side effects in cancer. In this literature review study, search was conducted with keywords like cancer, chemotherapy, mobile phone, information technology, side effects and self managing, in Science Direct, Google Scholar and Pub Med databases since 2005. Today, because of the growing trend of the cancer, we need methods and innovations such as information technology to manage and control it. Mobile phone based systems are the solutions that help to provide quick access to monitor chemotherapy side effects for cancer patients at home. Investigated studies demonstrate that using of mobile phones in chemoth...
Patient Online Self-Reporting of Toxicity Symptoms During Chemotherapy
Journal of Clinical Oncology, 2005
Purpose Tracking symptoms related to treatment toxicity is standard practice in routine care and during clinical trials. Currently, clinicians collect symptom information via complex and often inefficient mechanisms, but there is growing interest in collecting outcome information directly from patients. Patients and Methods The National Cancer Institute Common Terminology Criteria for Adverse Events schema for seven common symptoms was adapted into a Web-based patient-reporting system, accessible from desktop computers in outpatient clinics and from home computers. Eighty patients with gynecologic malignancies beginning standard chemotherapy regimens were enrolled between April and September 2004. During an 8-week observation period, participants were encouraged to log in and report symptoms at each follow-up visit, or alternatively, to access the system from home. Results All patients completed an initial log in. At each subsequent appointment, most enrollees (80% to 85%) reported ...
BMJ, 2021
ObjectiveTo evaluate the effectiveness of remote proactive management of toxicities during chemotherapy for early stage breast cancer.DesignPragmatic, cluster randomised trial.Setting20 cancer centres in Ontario, Canada, allocated by covariate constrained randomisation to remote management of toxicities or routine care.ParticipantsAll patients starting adjuvant or neoadjuvant chemotherapy for early stage breast cancer at each centre. 25 patients from each centre completed patient reported outcome questionnaires.InterventionsProactive, standardised, nurse led telephone management of common toxicities at two time points after each chemotherapy cycle.Main outcome measuresThe primary outcome, cluster level mean number of visits to the emergency department or admissions to hospital per patient during the whole course of chemotherapy treatment, was evaluated with routinely available administrative healthcare data. Secondary patient reported outcomes included toxicity, self-efficacy, and q...