Breakthrough in Electronic Symptom Tracking for Cancer Patients

Patients with metastatic cancer who regularly report their symptoms via a home-based electronic monitoring system experienced improved quality of life, better clinical outcomes and fewer emergency department visits than those who didn’t file reports. Those are the results of a groundbreaking study conducted by researchers from ChristianaCare’s Helen F. Graham Cancer Center & Research Institute and colleagues published in Nature Medicine on Feb. 7. The PRO-TECT randomized clinical trial was conducted in 52 community oncology practices in 26 states to assess the real-world impact of electronic patient-reported outcomes (ePRO) symptom monitoring on clinical outcomes compared to usual care.

“We’ve always known that cancer treatment can be physically and emotionally taxing, and one of the biggest challenges in patient care is addressing symptoms in real-time,” said Jon Strasser, M.D., radiation oncologist at the Graham Cancer Center and co-author of the article.

“This study is a game-changer. By using digital symptom monitoring, we can proactively manage side effects, adjust treatments to keep patients healthier at home through early interventions and empower patients to feel more in control by participating in their care.” The study enrolled 1,191 patients. To determine if symptom monitoring with the electronic PRO system improved outcomes, 593 of the patients were randomly assigned to the PRO arm and 598 were assigned to the usual care/control arm. Patients in the PRO arm reported their symptoms using a web-based program or an automated telephone system.

While there was no overall survival difference between patients who used PRO and those who did not, there were numerous quality-of-life benefits:

• There was a 16% longer time before a first emergency visit and 6.1% reduction in emergency visits with PRO compared to usual care.
• Patients in the PRO arm experienced a significant delay in deterioration of physical function, a 31% delay in symptoms and a 28% improvement in health-related quality-of-life factors compared to those who did not use PRO.
• Most patients felt that PRO improved discussions with their care team (77%), made them feel more in control of their care (84%) and would recommend it to other patients (91%).

“These are meaningful outcomes,” Strasser said. “The final results of this study reinforce the importance of patient-reported outcomes to keep patients healthier at home through early intervention, which puts less stress on hospitals. "Real-time symptom monitoring should be integrated into the cancer care we provide.”