Data presented at the 2021 ASCO Quality Care Symposium shows home-based symptom monitoring using patient-reported outcomes has the potential to improve quality of life, reduce symptom burdens, and decrease hospitalizations.

In a prospective single-arm pilot study conducted between September 1, 2020, and May 19, 2021, researchers evaluated the early feasibility of home-based symptom monitoring for clinicians treating patients with multiple myeloma (MM) and acute myeloid leukemia (AML). The study included a two-part education and technology intervention.

Included participants were aged 60 years or older and awaiting a treatment decision. At baseline, participants filled out a survey before enrolling in the PROmpt symptom monitoring platform, which utilized text messages and emails to monitor weekly symptoms. The platform then auto-generated a self-management plan based on electronic patient-reported outcomes. If patients reported severe symptoms (scores >7/10), clinical nurses received an alert.

During the study period, a total of 114 patients were screened, 77 were approached, and 35 were enrolled—18 of which had MM and 17 with AML.

“Outcomes for this study included proportion of patient approach who agreed to participate, patient completion rates (completion of weekly surveys), compliance rate (completion of total surveys), number of alerts generated, and type of alert. Feasibility was defined as a completion rate of >70%,” explained the researchers.
Patients who opted not to participate, top reasons included the patient: not seeking care at the institution, unsure-ness, lack of interest, lack of smartphone, ineligibility, and outright declination.

After 13 weeks, 195 of 220 surveys were completed by patients with AML (89% compliance), and 192 of 233 surveys were completed by patients with MM (82% compliance). Completion rates were 92% and 94%, respectively. Patients with AML or MM completed and average of 9 or 8 surveys individually.

In total, 294 moderate to severe alerts were generated among both AML and MM patients. A breakdown of reported severe alerts is as follows:

• Patients with AML: 40 fatigue, 25 constipation, 21 pain, 17 decreased appetite, 11 insomnia, 11 rash, 6 anxiety, 7 dyspnea/cough, 7 diarrhea, 5 depression/sadness, 4 nausea/ vomiting, 4 mouth/ throat sores, 3 neuropathy, 3 fever, and 2 alerts for other symptoms.
• Patients with MM: 35 pain, 21 constipation, 18 fatigue, 11 rash, 10 neuropathy, 9 anxiety, 7 insomnia, 6 depression/sadness, 4 decreased appetite, 4 other symptom, and 1 nausea/vomiting alert

“This study demonstrated early feasibility with over 80% of patients completing their surveys with a high compliance rate,” study authors wrote. “Future analysis will include both final implementation outcomes as well as patient outcomes for all patients within the study.”

Reference:
Dent D, Ingram SA, Lawhon V, et al. Patient responses to weekly electronic patient-reported outcomes. J Clin Oncol. 2021;39(suppl 28; abstr 182). doi:10.1200/JCO.2020.39.28