Cancer treatment can elicit a wide range of symptoms, adding a significant burden to the physical and emotional well-being of patients. Due to this burden, patients’ symptoms often remain underreported. In addition, doctors typically focus more on treatment efficacy than the side effects associated with therapy. The impact underreporting of symptoms has on outcomes and quality remains largely unexplored.
To address the impact of underreported symptoms, a team of researchers developed a clinical trial (NCT03249090) that compared outcomes between patients who underwent symptom monitoring and those who did not. To monitor symptoms, patients used electronic patient-reported outcomes (PROs). The study’s results, recently published in Nature Medicine, show that PROs can improve quality of life and reduce the need for emergency care.
Patients from 52 oncology practices participated in the study. Some practices were randomly assigned to use PRO protocols, and others continued with usual care, which typically involves regular check-ups and patient-initiated visits for symptom management. Over 1,000 patients enrolled in the study. Patients receiving treatment at one of the PRO practices completed electronic weekly surveys about their symptoms. If a patient reported severe symptoms, or a particular symptom that worsened from the previous reporting period, the relevant medical practitioners received a notification to intervene as needed.
The analysis looked at various outcomes, including overall survival, emergency visits, time to deterioration of physical functions, symptoms, health-related quality of life (HRQL), and patient satisfaction.
The researchers observed no difference in survival between PRO and usual care. Patients at PRO practices had 6.1% fewer emergency visits, which is significant given the potential stress and disruption these visits can cause. The time to their first emergency visit was longer than those with normal care, indicating a delay in the onset of severe symptoms. Delays in the deterioration of physical function, fewer symptoms, and better HRQL also favored PRO practices.
Most PRO patients (77%) reported that participation in PRO significantly improved their discussions with their healthcare providers, indicating a promising future for patient-provider interactions. Also, most PRO patients (84%) felt that PRO empowered them to have more control in their care. Notably, 91.4% of PRO patients reported that they would recommend symptom reporting to others.
The study also reports a reassuringly high compliance rate, with 91.5% of patients at PRO practices completing the expected weekly surveys, indicating the feasibility of implementing PRO practices. The researchers conclude that symptom monitoring via PRO can improve outcomes and quality of life. The ease of participation and compliance rate suggests doctors could easily add such mechanisms to standard cancer care practices.
Sources: Nature Med
