Sharing symptoms online boosts cancer patients’ survival
Sharing symptoms online boosts cancer patients’ survival8 Dec 2015
Asking cancer patients to periodically report their symptoms online may improve their quality of life and possibly even their survival, according to a new study. Researchers found that patients who used a website to report their symptoms had better quality of life, were less likely to go to the emergency room, stayed on treatment longer and survived longer than people who were just monitored by their doctors.
"We asked people about the most common and impactful symptoms that we would see across advanced cancers," said lead author Dr. Ethan Basch of the Lineberger Comprehensive Cancer Center at the University of North Carolina in Chapel Hill. "This would be pain, vomiting, nausea, diarrhea, constipation, energy loss, weight loss and sleep disturbances. Things that are highly common, subjective and frequently missed."
He and his colleagues report that these so-called patient-reported outcome (PRO) standardized questionnaires had been suggested as a way to improve symptom control, but researchers didn't know whether the benefits outweighed the cost and burden of using them.
Improving the quality of life by reporting cancer treatment symptoms
For the new study, the researchers asked 539 patients with advanced cancers at Memorial Sloan Kettering Cancer Center in New York to report 12 symptoms using tablets that were provided to them or at a computer kiosk. Doctors received printouts of the symptom surveys when the patients came in for their next visit, and nurses received emails if the patients reported severe or worsening symptoms.
The participants entered the study between September 2007 and January 2011. They spent an average of about four months participating in the study and had an average of 16 doctor visits in that time.
According to the research team:
- The nurses took action 75% of the time when they got one of these email alerts
- Another 227 patients with advanced cancers received usual care, which included normal symptom monitoring by their doctors.
- Over the study period, people who answered the online surveys were more likely to see improvements in their quality of life than those in the usual care group.
- Patients who answered the surveys were also less likely to report worsening quality of life.
- About a third of patients who answered the survey ended up in the emergency department, compared to about 41% of the usual care group.
- Patients using the symptom reporting tool also stayed on their chemotherapy longer than those who didn't use it.
- About 75% of patients who answered the surveys were alive after one year, compared to 69% of those in the usual care group.
Showing the importance of patient-reported outcomes
Cancer care providers can improve the quality of their care by having a better understanding of their patients, Basch said. And even without these types of computer systems, patients can likely benefit from closely following their own symptoms and reporting them to their doctors.
"I think this study is really helpful in showing patient-reported outcomes can be used to identify and address patient issues by both improving the patient-centeredness of care and the precision of care," said Claire Snyder, of the Johns Hopkins School of Medicine and the Bloomberg School of Public Health in Baltimore.
The results also validate the value of having a standard practice in place for collecting this information and tracking it over time, said Snyder, who is president of the International Society for Quality of Life Research and co-authored an editorial accompanying the new studySource: Reuters