Electronic patient-reported outcome (ePRO) symptom monitoring
Patients report symptoms weekly through an app or web form, and nurses respond to alerts. Randomised trials showed this simple system improved quality of life, cut emergency visits and, in one trial, extended survival by five months.
Basch's MSK trial (JCO 2016; JAMA 2017) randomised 766 patients on chemotherapy to weekly web-based symptom reporting with nurse alerts versus usual care: better quality of life, fewer ER visits, more chemotherapy tolerated, and OS 31.2 vs 26.0 months. The French Moovcare trial (Denis, JNCI 2017) in lung cancer follow-up showed OS 22.5 vs 14.9 months with weekly symptom-based relapse detection. PRO-TECT (Basch, JAMA 2022) in 52 US community practices confirmed quality-of-life and physical-function benefits. ePRO is now a CMS Enhancing Oncology Model requirement and an FDA-endorsed trial endpoint (PRO-CTCAE). Implementation issues: alert fatigue, digital divide, integration with EHRs and reimbursement.
How it works
Systematic, frequent capture of patient-reported symptoms with threshold-triggered clinician alerts to detect deterioration earlier than scheduled visits allow, enabling prompt intervention.
- Randomised evidence for quality of life, utilisation and survival
- Low cost; scalable through existing portals
- Standardised instruments (PRO-CTCAE, ESAS)
- Requires responsive nursing capacity
- Digital literacy and language barriers
- Alert fatigue if thresholds poorly set
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.
Palliative care is not what happens when treatment stops; it works best alongside cancer treatment from the start. Patients feel better, are less depressed and may live longer. Access remains the constraint: most of the world's patients never see a palliative care specialist.
Latest papers
topQuery for this technology: (TITLE:"Electronic patient-reported outcome ePRO symptom monitoring" OR ABSTRACT:"Electronic patient-reported outcome ePRO symptom monitoring") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Electronic patient-reported outcome (ePRO) symptom monitoring, not a curated reading list.