Digital symptom tracker improves quality of life for chemotherapy patients 

Cancer patients going through chemotherapy whose symptoms were tracked with remote technology have experienced an improvement in quality of life and reduction in anxiety.

Researchers at the University of Strathclyde believe the 24-hour phone-based system, which was developed with British digital health solutions company Docobo, will make a “meaningful difference to people with cancer”.

With blended models of care delivery arising from the pandemic and the digital tracker enabling patients to remain at home, it will be “vital for future services”.

Effective symptom monitoring and management is essential during chemotherapy for cancer, but current approaches rely on patients recognising that symptoms are severe enough to warrant reporting to their care team.

The new findings are based on 829 patients aged 18 or older, diagnosed with breast cancer, colorectal cancer, Hodgkin’s disease, or non-Hodgkin’s lymphoma, and receiving chemotherapy at 12 cancer centres in Austria, Greece, Norway, the Republic of Ireland and the UK.

Over six cycles of chemotherapy, patients were randomly allocated to the intervention group – 24-hour symptom monitoring via the advanced symptom management system (ASyMS), or the control group – standard care at their cancer centre.

Intervention patients completed a daily symptom questionnaire on a handheld ASyMS device, which generated alerts to hospital clinicians if action was needed. They were also provided with self-care advice providing them with information on how to manage their symptoms themselves.

The researchers found that for the intervention group, ‘symptom burden’ remained at pre-chemotherapy treatment levels, whereas the control group reported an increase from cycle one onwards.

Symptom burden is a concept that encompasses both the severity of the symptoms and the patient’s perception of the impact of the symptoms – it can produce multiple negative, physical, and emotional patient responses.

Analysis indicated significant reductions in favour of ASyMS for psychological and physical symptoms and for level of distress associated with each symptom.

Health related quality of life scores were higher in the intervention group across all cycles, while average scores for anxiety were lower.

Measures of cancer patients’ confidence and ability to engage in their care were also higher in the intervention group, and most supportive care needs were lower, including sexual-related needs and physical and daily living needs.

Other areas of supportive care needs and work limitations were similar in both groups, and the safety of ASyMS was “satisfactory”.

Team leader Professor Roma Maguire, of the University of Strathclyde’s department of computer and information sciences, said: “With the majority of chemotherapy being delivered on an outpatient basis, what is important is to develop person centred technologies that support people with cancer at home during periods when they are not at the hospital.

“Currently after receiving chemotherapy, most people have to go home and manage the symptoms and side-effects associated with their treatment on their own and importantly be able to recognise when their symptoms are severe enough for them to contact health professionals at their hospital. This can cause delays in reporting symptoms and cause significant anxiety to the individual involved.

“ASyMS can overcome many of these challenges by enabling people with cancer to report their symptoms in real time, provide them with immediate information to assist them in managing symptoms and importantly alerting health professionals in their hospital when their symptoms warrant it.

“Our study demonstrates the benefits of remote patient monitoring on important patient outcomes including symptom burden, quality of life, supportive care needs and anxiety. The findings of our European study, combined with the existing evidence base, support the use of remote patient monitoring technologies such as ASyMS to support people with cancer during chemotherapy treatment.” 

According to the collaborative team, this is the largest trial to date of remote monitoring of symptoms during chemotherapy for cancers being treated with curative intent, and its robust design avoided many limitations of previous studies.

The study also involved the Universities of Dundee, Surrey and Glasgow, King’s College London, University College Dublin, NHS24, National and Kapodistrian University of Athens, the Medical University of Vienna, the European Cancer Patient Coalition, and Norwegian health authority Sykehuset Innlandet HF.

The research was funded by the European Commission via the FP7-HEALTH-2013-INNOVATION-1 grant award scheme.