Electronic symptom monitoring in patients with metastatic lung cancer: a feasibility study

Friis, Rasmus Blechingberg; Hjøllund, Niels Henrik; Mejdahl, Caroline Trillingsgaard; Pappot, Helle; Skuladottir, Halla

doi:10.1136/bmjopen-2019-035673

Cited by 16 publications

(21 citation statements)

References 37 publications

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“…The included studies had a sample size ranging from 6 [ 61 ] to 766 [ 31 ] and included multiple RCTs (16/39, 41%) [ 30 , 31 , 33 - 35 , 37 - 39 , 43 - 45 , 48 , 50 , 57 , 63 , 67 , 68 ], with most studies being conducted in the United States (22/39, 56%) [ 29 - 31 , 33 , 34 , 37 - 41 , 43 , 45 , 46 , 48 , 50 , 54 , 57 , 59 , 60 , 66 - 68 ]. Of the 39 studies included in the review, 13 (33%) explored intervention effects in the context of routine care implementation [ 29 , 32 , 36 , 41 , 42 , 49 , 51 , 52 , 58 , 60 - 62 , 64 ], with the remainder exploring intervention effects often using a blinded controlled trial design.…”

Section: Resultsmentioning

confidence: 99%

“…Across most studies (36/39, 92%), the frequency of times contact was made with the intervention was reported [ 29 - 43 , 45 - 47 , 49 - 58 , 60 - 68 ]. There was substantial heterogeneity in the measurement of frequency across studies.…”

Section: Resultsmentioning

confidence: 99%

“…The included studies had a sample size ranging from 6 [61] to 766 [31] and included multiple RCTs (16/39, 41%) [30,31,[33][34][35][37][38][39][43][44][45]48,50,57,63,67,68], with most studies being conducted in the United States (22/39, 56%) [29][30][31]33,34,[37][38][39][40][41]43,45,46,48,50,54,57,59,60,[66][67][68]. Of the 39 studies included in the review, 13 (33%) explored intervention effects in the context of routine care implementation [29,32,36,41,42,49,51,52,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Across most studies (36/39, 92%), the frequency of times contact was made with the intervention was reported [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][45][46][47][49][50][51][52][53][54][55][56][57][58][60][61][62][63][64][65][66][67][68]. There was substantial heterogeneity in the measurement of frequency across studies.…”

Section: Frequencymentioning

confidence: 99%

“…There was substantial heterogeneity in the measurement of frequency across studies. Of the 39 studies, 13 (33%) reported the percentage of contacts either with the whole intervention or with each individual intended session [30,31,35,40,[48][49][50]54,56,63,65,66,68]. The number of contacts with the intervention overall or each individual session was reported by 69% (27/39) of the studies [29,33,34,[36][37][38][39][41][42][43]45,46,49,[51][52][53][54][55]57,58,[60][61][62][63][64][65][66][67].…”

Section: Frequencymentioning

confidence: 99%

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The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review

Goodman¹,

Bagnall²,

Ashley³

et al. 2022

JMIR Cancer

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Background Telehealth approaches are increasingly being used to support patients with advanced diseases, including cancer. Evidence suggests that telehealth is acceptable to most patients; however, the extent of and factors influencing patient engagement remain unclear. Objective The aim of this review is to characterize the extent of engagement with telehealth interventions in patients with advanced, incurable cancer reported in the international literature. Methods This systematic review was registered with PROSPERO (International Prospective Register of Systematic Reviews) and is reported in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines. A comprehensive search of databases was undertaken for telehealth interventions (communication between a patient with advanced cancer and their health professional via telehealth technologies), including MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Sociological Abstracts, and Web of Science, from the inception of each electronic database up until December 31, 2020. A narrative synthesis was conducted to outline the design, population, and context of the studies. A conceptual framework of digital engagement comprising quantitative behavioral measures (frequency, amount, duration, and depth of use) framed the analysis of engagement with telehealth approaches. Frequency data were transformed to a percentage (actual patient engagement as a proportion of intended engagement), and the interventions were characterized by intensity (high, medium, and low intended engagement) and mode of delivery for standardized comparisons across studies. Results Of the 19,676 identified papers, 40 (0.2%) papers covering 39 different studies were eligible for inclusion, dominated by US studies (22/39, 56%), with most being research studies (26/39, 67%). The most commonly reported measure of engagement was frequency (36/39, 92%), with substantial heterogeneity in the way in which it was measured. A standardized percentage of actual patient engagement was derived from 17 studies (17/39, 44%; n=1255), ranging from 51% to 100% with a weighted average of 75.4% (SD 15.8%). A directly proportional relationship was found between intervention intensity and actual patient engagement. Higher engagement occurred when a tablet, computer, or smartphone app was the mode of delivery. Conclusions Understanding engagement for people with advanced cancer can guide the development of telehealth approaches from their design to monitoring as part of routine care. With increasing telehealth use, the development of meaningful and context- and condition-appropriate measures of telehealth engagement is needed to address the current heterogeneity in reporting while improving the understanding of optimal implementation of telehealth for oncology and palliative care. Trial Registration PROSPERO (International Prospective Register of Systematic Reviews) CRD42018117232; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018117232

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Frequencymentioning

confidence: 99%

Section: Frequencymentioning

confidence: 99%

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The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review

Goodman¹,

Bagnall²,

Ashley³

et al. 2022

JMIR Cancer

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Essential barriers and considerations for the implementation of electronic patient-reported outcome (ePRO) measures in oncological practice: contextualizing the results of a feasibility study with existing literature

Kiderlen

Schnack

Wit

2022

J Public Health (Berl.)

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Aim Monitoring electronic patient-reported outcomes (ePRO) can provide various benefits to cancer patients, such as enhanced quality of life, reduction of hospital admissions, and even prolonged survival. Furthermore, ePRO might offer significant benefits to patients under antineoplastic treatment in the context of the current COVID-19 pandemic. However, evidence on feasibility of ePRO in routine cancer care and barriers met in a real-life setting remains limited. Subject and methodsWe conducted a feasibility study among patients diagnosed with multiple myeloma currently under antineoplastic treatment. Patients filled out weekly ePRO questionnaires and were followed up for 6 months. In case of adverse events, an alert was sent to the clinic. We assessed uptake and adherence, as well as subjective perceptions of patients and clinic staff. A semi-structured literature review was conducted to contextualize results. Results Eleven patients were recruited and followed up for 6 months. Overall adherence was found at a high level and remained stable throughout the study period. Feedback from patients was positive; however, clinic staff expressed disappointment and frustration, criticising an increase of workload while not perceiving any benefit to the oncological treatment. Both findings were backed by evidence we found in literature. Conclusions Implementation of ePRO monitoring to routine cancer treatment seems to be feasible regarding patients' acceptance and compliance. However, integration of the tool into clinical workflow without increasing workload and deterring clinicians proves to be a major challenge.

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Patient-reported outcome (PRO) measurements in chronic and malignant diseases: ten years’ experience with PRO-algorithm-based patient-clinician interaction (telePRO) in AmbuFlex

et al. 2023

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Background Patient-reported Outcome (PRO) measures may be used as the basis for out-patient follow-up instead of fixed appointments. The patients attend follow-up from home by filling in questionnaires developed for that specific aim and patient group (telePRO). The questionnaires are handled in real time by a specific algorithm, which assigns an outcome color reflecting clinical need. The specific questionnaires and algorithms (named solutions) are constructed in a consensus process with clinicians. We aimed to describe AmbuFlex’ telePRO solutions and the algorithm outcomes and variation between patient groups, and to discuss possible applications and challenges. Methods TelePRO solutions with more than 100 processed questionnaires were included in the analysis. Data were retrieved together with data from national registers. Characteristics of patients, questionnaires and outcomes were tabulated for each solution. Graphs were constructed depicting the overall and within-patient distribution of algorithm outcomes for each solution. Results From 2011 to 2021, 29 specific telePRO solutions were implemented within 24 different ICD-10 groups. A total of 42,015 patients were referred and answered 171,268 questionnaires. An existing applicable instrument with cut-off values was available for four solutions, whereas items were selected or developed ad hoc for the other solutions. Mean age ranged from 10.7 (Pain in children) to 73.3 years (chronic kidney disease). Mortality among referred patients varied between 0 (obesity, asthma, endometriosis and pain in children) and 528 per 1000 patient years (Lung cancer). There was substantial variation in algorithm outcome across patient groups while different solutions within the same patient group varied little. Discussion TelePRO can be applied in diseases where PRO can reflect clinical status and needs. Questionnaires and algorithms should be adapted for the specific patient groups and clinical aims. When PRO is used as replacement for clinical contact, special carefulness should be observed with respect to patient safety.

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Electronic symptom monitoring in patients with metastatic lung cancer: a feasibility study

Cited by 16 publications

References 37 publications

The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review

The Extent of Engagement With Telehealth Approaches by Patients With Advanced Cancer: Systematic Review

Essential barriers and considerations for the implementation of electronic patient-reported outcome (ePRO) measures in oncological practice: contextualizing the results of a feasibility study with existing literature

Patient-reported outcome (PRO) measurements in chronic and malignant diseases: ten years’ experience with PRO-algorithm-based patient-clinician interaction (telePRO) in AmbuFlex

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