Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial

Mir, Olivier; Ferrua, Marie; Fourcade, A.; Mathivon, Delphine; Duflot-Boukobza, Adeline; Dumont, Sarah; Baudin, Éric; Delaloge, Suzette; Malka, David; Albigès, Laurence; Pautier, Patricia; Robert, Caroline; Planchard, David; Botton, Stéphane de; Scotté, Florian; Lemare, François; Abbas, Moncef; Guillet, Marilene; Puglisi, V.; Palma, Mario Di; Minvielle, Étienne

doi:10.1038/s41591-022-01788-1

Cited by 74 publications

(48 citation statements)

References 48 publications

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“…8 Prior studies have reported improved outcomes for physical function, symptom control, health-related quality of life (HRQOL), hospitalizations, and survival when such electronic systems are used by patients receiving cancer treatment. [8][9][10][11][12][13][14] Integrating symptom monitoring into routine treatment of cancer may improve outcomes with an opportunity for reimbursement by payers. 15 Based on findings from a prior single-center study, 10 a multicenter randomized clinical trial, the PRO-TECT trial (Alliance AFT-39), was conducted across 52 US-based community oncology practices to determine whether electronic monitoring of symptoms by patients undergoing treatment for metastatic cancer improves survival, QOL outcomes, and other outcomes compared with usual care.…”

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confidence: 99%

Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer

Basch

Schrag

Henson

et al. 2022

JAMA

188

128

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IMPORTANCE Electronic systems that facilitate patient-reported outcome (PRO) surveys for patients with cancer may detect symptoms early and prompt clinicians to intervene. OBJECTIVE To evaluate whether electronic symptom monitoring during cancer treatment confers benefits on quality-of-life outcomes. DESIGN, SETTING, AND PARTICIPANTS Report of secondary outcomes from the PRO-TECT (Alliance AFT-39) cluster randomized trial in 52 US community oncology practices randomized to electronic symptom monitoring with PRO surveys or usual care. Between October 2017 and March 2020, 1191 adults being treated for metastatic cancer were enrolled, with last follow-up on May 17, 2021. INTERVENTIONSIn the PRO group, participants (n = 593) were asked to complete weekly surveys via an internet-based or automated telephone system for up to 1 year. Severe or worsening symptoms triggered care team alerts. The control group (n = 598) received usual care. MAIN OUTCOMES AND MEASURESThe 3 prespecified secondary outcomes were physical function, symptom control, and health-related quality of life (HRQOL) at 3 months, measured by the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30; range, 0-100 points; minimum clinically important difference [MCID], 2-7 for physical function; no MCID defined for symptom control or HRQOL). Results on the primary outcome, overall survival, are not yet available. RESULTS Among 52 practices, 1191 patients were included (mean age, 62.2 years; 694 [58.3%] women); 1066 (89.5%) completed 3-month follow-up. Compared with usual care, mean changes on the QLQ-C30 from baseline to 3 months were significantly improved in the PRO group for physical function (PRO, from 74.27 to 75.81 points; control, from 73.54 to 72.61 points; mean difference, 2.47 [95% CI,]; P = .02), symptom control (PRO, from 77.67 to 80.03 points; control, from 76.75 to 76.55 points; mean difference, 2.56 [95% CI, 0.95-4.17]; P = .002), and HRQOL (PRO, from 78.11 to 80.03 points; control, from 77.00 to 76.50 points; mean difference, 2.43 [95% CI, 0.90-3.96]; P = .002). Patients in the PRO group had significantly greater odds of experiencing clinically meaningful benefits vs usual care for physical function (7.7% more with improvements of Ն5 points and 6.1% fewer with worsening of Ն5 points; odds ratio [OR], 1.35 [95% CI, 1.08-1.70];

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mentioning

confidence: 99%

Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer

Basch

Schrag

Henson

et al. 2022

JAMA

188

128

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“…The pragmatic and well-conducted trial reported by Mir et al 5 illustrates the importance of multidisciplinary commitment to digital innovations in cancer care, and confirms that a combination of patient-reported outcomes, specialist nursing support and carefully designed technology 11…”

Section: News Andmentioning

confidence: 71%

“…It is no coincidence that the results described by Mir et al 5 were achieved in the context of a nurse navigator-led system of care, whereby the nurse navigators provided the crucial link between the patient, the hospital and primary care professionals, and the web portal. There is increasing evidence of the role and effectiveness of nurse-led interventions in cancer care 9,10 and this trial provides further reassurance that skilled nurses can manage the vast majority of clinical interventions without referral to an oncologist.…”

Section: News Andmentioning

confidence: 92%

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Key components of successful digital remote monitoring in oncology

Wells

2022

Nat Med

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“…These visits allow patients in rural areas, those with limited mobility, and those with transportation challenges ease of access to specialized palliative care teams. Another potentially useful telemedicine strategy is telemonitoring, in which symptom scores, vital signs, and other parameters can be monitored remotely with predefined prompts for self-management and real-time triggers for interventions by the health care team [ 12 ]. However, regional regulations, reimbursement policies, and access to the Internet and devices for video conferencing may pose challenges to telemedicine delivery.…”

Section: Outpatient Palliative Carementioning

confidence: 99%

Personalizing the Setting of Palliative Care Delivery for Patients with Advanced Cancer: “Care Anywhere, Anytime”

Hui

Paiva

2022

Curr. Treat. Options in Oncol.

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Opinion statement The specialty of palliative care has evolved over time to provide symptom management, psychosocial support, and care planning for patients with cancer throughout the disease continuum and in multiple care settings. This review examines the delivery and impact of palliative care in the outpatient, inpatient, and community-based settings. The article will discuss how these 3 palliative care settings can work together to optimize patient outcomes under a unifying model of palliative care “anywhere, anytime” and how to prioritize palliative care services when resources are limited. Many patients with advanced cancer receive care from each of the 3 branches of palliative care—outpatient, inpatient, and community-based settings—at some point along their disease trajectory. Early on, outpatient clinics provide longitudinal supportive care concurrent with active disease-modifying treatments. Telemedicine appointments can serve patients remotely to minimize their need to travel. When patients experience functional decline, community-based palliative care services can provide support and monitoring for patients at home. When patients develop acute symptomatic complications requiring admission, inpatient care consultation teams are essential for symptom management and goals-of-care discussions. For patients in severe distress, receiving care in a palliative care unit that provides intensive symptom control and facilitates complex discharge planning is ideal. Under a unifying model of palliative care designed to offer care “anywhere, anytime,” the 3 branches of palliative care could work in unison to support each other, minimize gaps in care, and optimize patient outcomes.

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Digital remote monitoring plus usual care versus usual care in patients treated with oral anticancer agents: the randomized phase 3 CAPRI trial

Cited by 74 publications

References 48 publications

Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer

Effect of Electronic Symptom Monitoring on Patient-Reported Outcomes Among Patients With Metastatic Cancer

Key components of successful digital remote monitoring in oncology

Personalizing the Setting of Palliative Care Delivery for Patients with Advanced Cancer: “Care Anywhere, Anytime”

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