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Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART)
- Source :
- The BMJ
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- Objective To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations. Design Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial. Setting Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK. Participants 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin’s disease, or non-Hodgkin’s lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years. Intervention Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy. Main outcome measures The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy—General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory—Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ). Results For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference −0.15, 95% confidence interval −0.19 to −0.12; P Conclusions Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A “medium” Cohen’s effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients’ symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic. Trial registration Clinicaltrials.gov NCT02356081 .
- Subjects :
- QA75
Adult
Male
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
Colorectal cancer
Breast Neoplasms
Disease
Corrections
law.invention
RC0254
03 medical and health sciences
0302 clinical medicine
Breast cancer
Quality of life (healthcare)
Randomized controlled trial
law
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
030212 general & internal medicine
Aged
Greece
Norway
business.industry
Research
Lymphoma, Non-Hodgkin
Repeated measures design
Cancer
General Medicine
Middle Aged
medicine.disease
Hodgkin Disease
Telemedicine
United Kingdom
Treatment Outcome
Chemotherapy, Adjuvant
Austria
030220 oncology & carcinogenesis
Quality of Life
Physical therapy
Anxiety
Female
medicine.symptom
Colorectal Neoplasms
business
Ireland
Cell Phone
Subjects
Details
- Language :
- English
- ISSN :
- 17561833 and 09598138
- Database :
- OpenAIRE
- Journal :
- The BMJ
- Accession number :
- edsair.doi.dedup.....c446c4780c44d893a76b6880950fa7eb