Electronic patient-reported outcomes extend lives of those with metastatic cancer

Researchers are hoping to improve engagement with electronic patient-reported outcomes (PROs) to increase survival rates in those with cancer. A study published by JAMA reported the integration of electronic PROs into routine care could improve outcomes in those with metastatic cancer.

Symptoms in individuals receiving treatment for advanced cancers often go unnoticed by clinicians. Ethan Basch, MD, of the Lineberger Comprehensive Cancer Center at the University of North Carolina, Chapel Hill, and colleagues integrated electronic PROs program into routine cancer care for symptom monitoring.

The program was evaluated against usual follow-up care in patients with metastatic solid tumors from September 2007 to January 2011. Participants were randomly assigned to join the PRO group—where they provided self-reports of 12 common symptoms and used a web-based PRO questionnaire platform—or a control group with standard follow-up care. Additionally, PRO participants who reported severe symptoms could send email alerts to clinical nurses.

Researchers studied data from June 2016, after 517 of the 766 patients had died, to analyze the platform's effect on survival. Results showed that participants using the PRO platform had an average survival of 31.2 months versus 26 months with usual care.

“One potential mechanism of action is early responsiveness to patient symptoms preventing adverse downstream consequences,” concluded Basch and colleagues. “Nurses responded to symptom alerts 77 percent of the time with discrete clinical interventions including calls to provide symptom management counseling, supportive medications, chemotherapy dose modifications, and referrals. Another potential mechanism is that patients in the intervention group were able to tolerate continuation of chemotherapy longer than usual care.”