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Patients on cancer treatment who report their symptoms every week through an app or phone line, with nurses acting on alerts, feel better and go to the emergency department less. Two early trials also found longer survival, but the largest trial, designed to test survival, found no difference. The quality-of-life benefit is reason enough to make it routine and paid for.
Randomised trials show that routine electronic patient-reported outcome monitoring with a nurse responding to alerts improves quality of life and reduces emergency visits. Basch and colleagues randomised 766 patients at one cancer centre (JCO 2016) and later reported longer overall survival (JAMA 2017), and a French trial in 133 patients with lung cancer under follow-up also reported longer survival (Denis, JNCI 2017). PRO-TECT, which cluster-randomised 52 United States community practices and 1,191 patients with overall survival as its primary outcome, found no survival difference (hazard ratio 0.99) but confirmed better physical function, quality of life and symptom control and fewer emergency visits. The investigators name the barriers to adoption as no protected nursing time to answer alerts, software that does not connect to the health record, and no payment outside specific models. The proposal is to make PRO monitoring a reimbursed standard of care during systemic therapy, with minimum response standards and open symptom item sets.
One technology page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Routinely asking patients how they feel between visits, and acting on the answers, is a treatment in itself. It catches problems early, keeps people on effective therapy longer and appears to extend life. Cancer centres now build symptom monitoring into electronic records, though implementation is uneven.
Shares Fragmented care and guideline gaps, Toxicity and quality of life are undervalued and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Fragmented care and guideline gaps and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Toxicity and quality of life are undervalued and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Toxicity and quality of life are undervalued and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Toxicity and quality of life are undervalued and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Fragmented care and guideline gaps and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Fragmented care and guideline gaps and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Fragmented care and guideline gaps and the tags protocol-upgrade, upgrade:proven-unevenly-used.
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