Electronic monitoring enhances well-being and slows the progression of symptoms in cancer patients.

According to researchers from the Lineberger Comprehensive Cancer Center at the University of North Carolina and their colleagues, overall survival rates were identical in both patient categories.

The results of the national multicenter study were published in the journal Nature Medicine.

Ethan Basch, MD, lead author of the study, distinguished professor of medicine, head of the medical oncology division at the UNC School of Medicine, and director of the UNC Lineberger Cancer Outcomes Research Program

The randomized clinical trial PRO-TECT was conducted in 52 community oncology clinics across 26 states to assess the real impact of electronic symptom monitoring through the Patient-Reported Outcomes Symptom Monitoring System (PROSMS) on clinical outcomes compared to standard care.

A total of 1,191 patients participated in the study. To determine whether symptom monitoring via the electronic PROSMS improved outcomes, approximately half (593) of the patients were randomly assigned to the PROSMS group, while the remaining (598) were assigned to the usual care/control group. Patients in the PROSMS group were able to report their symptoms using an online program or an automated telephone system.

The average age of participants was 63 years, with about 17% having never used the Internet, and roughly 26% of patients receiving treatment in rural areas.

Despite the lack of difference in overall survival between those using PROSMS and those not using the system (which was the primary outcome of the study), numerous benefits related to quality of life were noted:

• The number of emergency room visits for patients using PROSMS decreased by 6.1% compared to those receiving standard care. Additionally, the time to the first emergency visit increased by 16% with the use of PROSMS compared to usual care.
• Patients in the PROSMS group experienced a significant delay in the deterioration of physical function (12.6 months vs. 8.5 months), a 31% slowdown in symptom onset (12.7 months vs. 9.9 months), and a 28% improvement in health-related quality of life factors (15.6 months vs. 12.2 months) compared to patients who did not use PROSMS.
• The majority of patients felt that PROSMS improved the quality of consultations with their care team (77%), allowed them to better manage their treatment (84%), and these patients would recommend PROSMS to other cancer patients (91%).
• 91.5% of patients completed the scheduled weekly symptom surveys.

"Maintaining an electronic medical record has posed challenges for some doctors and patients who struggle to navigate patient portal systems, and addressing these inconveniences was a major focus in developing the PROSMS system for this study," says Basch. "PROSMS largely bypasses physicians and is managed by nurses and/or patient coordinators, whose work often involves tracking symptoms and coordinating care. The PROSMS systems also proved to be very user-friendly for patients from a technical standpoint."

The study was designed to be generalizable to all types of cancer and treatment modalities. The findings, based on data from dozens of cancer types represented in the patient sample, confirmed this universality.

While the final results of the PRO-TECT study have been obtained, researchers plan to conduct further analyses based on surveys of patients, nurses, and doctors; assess outcomes considering various patient characteristics such as cancer type, race, and geography; and perform various methodological evaluations of the PROSMS technology.