A randomized trial of weekly symptom telemonitoring in advanced lung cancer

Susan E. Yount*, Nan Rothrock, Michael Bass, Jennifer L. Beaumont, Deborah Pach, Thomas Lad, Jyoti Patel, Maria Corona, Rebecca Weiland, Katherine Del Ciello, David Cella

*Corresponding author for this work

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Context Lung cancer patients experience multiple, simultaneous symptoms related to their disease and treatment that impair functioning and health-related quality of life (HRQL). Computer technology can reduce barriers to nonsystematic, infrequent symptom assessment and potentially contribute to improved patient care. Objectives To evaluate the efficacy of technology-based symptom monitoring and reporting in reducing symptom burden in patients with advanced lung cancer. Methods This was a prospective, multisite, randomized controlled trial. Two hundred fifty-three patients were enrolled at three sites and randomized to monitoring and reporting (MR) or monitoring alone (MA). Patients completed questionnaires at baseline, 3, 6, 9, and 12 weeks and symptom surveys via interactive voice response weekly for 12 weeks. MR patients' clinically significant symptom scores generated an e-mail alert to the site nurse for management. The primary endpoint was overall symptom burden; secondary endpoints included HRQL, treatment satisfaction, symptom management barriers, and self-efficacy. Results This randomized controlled trial failed to demonstrate efficacy of symptom monitoring and reporting in reducing symptom burden compared with monitoring alone in lung cancer. HRQL declined over 12 weeks in both groups (P < 0.006 to P < 0.025); at week 12, treatment satisfaction was higher in MA than MR patients (P < 0.012, P < 0.027). Adherence to weekly calls was good (82%) and patient satisfaction was high. Conclusion Feasibility of using a technology-based system for systematic symptom monitoring in advanced lung cancer patients was demonstrated. Future research should focus on identifying patients most likely to benefit and other patient, provider, and health system factors likely to contribute to the system's success.

Original languageEnglish (US)
Pages (from-to)973-989
Number of pages17
JournalJournal of Pain and Symptom Management
Volume47
Issue number6
DOIs
StatePublished - Jun 2014

Keywords

  • Lung cancer
  • health information technology
  • randomized controlled trial
  • symptoms
  • telemonitoring

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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