Computerized patient reported symptom assessment in radiotherapy: a pilot randomized, controlled trial
Identifieur interne : 007A28 ( Ncbi/Merge ); précédent : 007A27; suivant : 007A29Computerized patient reported symptom assessment in radiotherapy: a pilot randomized, controlled trial
Auteurs : Erik K. Fromme ; Emma B. Holliday ; Lillian M. Nail ; Karen S. Lyons ; Michelle R. Hribar ; Charles R. ThomasSource :
- Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [ 0941-4355 ] ; 2015.
Abstract
Computer-based, patient-reported symptom survey tools have been described for patients undergoing chemotherapy. We hypothesized that patients undergoing radiotherapy might also benefit, so we developed a computer application to acquire symptom ratings from patients and generate summaries for use at point of care office visits and conducted a randomized-controlled pilot trial to test its feasibility.
Subjects were randomized prior to beginning radiotherapy. Both control and intervention group subjects completed the computerized symptom assessment, but only for the intervention group were printed symptom summaries made available before each weekly office visit. Metrics compared included the Global Distress Index (GDI), concordance of patient-reported symptoms and symptoms discussed by the physician and numbers of new and/or adjusted symptom management medications prescribed.
112 patients completed the study: 54 in the control and 58 in the intervention arms. There were no differences in GDI over time between the control and intervention groups. In the intervention group, more patient-reported symptoms were actually discussed in radiotherapy office visits: 46/202 vs. 19/230. A sensitivity analysis to account for within-subjects correlation yielded 23.2% vs. 10.3% (p=.03). Medications were started or adjusted at 15.4% (43/280) of control visits compared to 20.4% (65/319) of intervention visits (p=.07).
This computer application is easy to use and makes extensive patient-reported outcome data available at the point of care. Although no differences were seen in symptom trajectory, patients who had printed symptom summaries had improved communication during office visits and a trend towards more active symptom management during radiotherapy.
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DOI: 10.1007/s00520-015-2983-3
PubMed: 26471280
PubMed Central: 4769076
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PMC:4769076Le document en format XML
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<author><name sortKey="Fromme, Erik K" sort="Fromme, Erik K" uniqKey="Fromme E" first="Erik K." last="Fromme">Erik K. Fromme</name>
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<author><name sortKey="Holliday, Emma B" sort="Holliday, Emma B" uniqKey="Holliday E" first="Emma B." last="Holliday">Emma B. Holliday</name>
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<author><name sortKey="Nail, Lillian M" sort="Nail, Lillian M" uniqKey="Nail L" first="Lillian M." last="Nail">Lillian M. Nail</name>
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<author><name sortKey="Lyons, Karen S" sort="Lyons, Karen S" uniqKey="Lyons K" first="Karen S." last="Lyons">Karen S. Lyons</name>
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<author><name sortKey="Hribar, Michelle R" sort="Hribar, Michelle R" uniqKey="Hribar M" first="Michelle R." last="Hribar">Michelle R. Hribar</name>
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<author><name sortKey="Thomas, Charles R" sort="Thomas, Charles R" uniqKey="Thomas C" first="Charles R." last="Thomas">Charles R. Thomas</name>
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<author><name sortKey="Holliday, Emma B" sort="Holliday, Emma B" uniqKey="Holliday E" first="Emma B." last="Holliday">Emma B. Holliday</name>
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<author><name sortKey="Nail, Lillian M" sort="Nail, Lillian M" uniqKey="Nail L" first="Lillian M." last="Nail">Lillian M. Nail</name>
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<author><name sortKey="Lyons, Karen S" sort="Lyons, Karen S" uniqKey="Lyons K" first="Karen S." last="Lyons">Karen S. Lyons</name>
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<author><name sortKey="Hribar, Michelle R" sort="Hribar, Michelle R" uniqKey="Hribar M" first="Michelle R." last="Hribar">Michelle R. Hribar</name>
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<author><name sortKey="Thomas, Charles R" sort="Thomas, Charles R" uniqKey="Thomas C" first="Charles R." last="Thomas">Charles R. Thomas</name>
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<series><title level="j">Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</title>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Purpose</title>
<p id="P1">Computer-based, patient-reported symptom survey tools have been described for patients undergoing chemotherapy. We hypothesized that patients undergoing radiotherapy might also benefit, so we developed a computer application to acquire symptom ratings from patients and generate summaries for use at point of care office visits and conducted a randomized-controlled pilot trial to test its feasibility.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Subjects were randomized prior to beginning radiotherapy. Both control and intervention group subjects completed the computerized symptom assessment, but only for the intervention group were printed symptom summaries made available before each weekly office visit. Metrics compared included the Global Distress Index (GDI), concordance of patient-reported symptoms and symptoms discussed by the physician and numbers of new and/or adjusted symptom management medications prescribed.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">112 patients completed the study: 54 in the control and 58 in the intervention arms. There were no differences in GDI over time between the control and intervention groups. In the intervention group, more patient-reported symptoms were actually discussed in radiotherapy office visits: 46/202 vs. 19/230. A sensitivity analysis to account for within-subjects correlation yielded 23.2% vs. 10.3% (p=.03). Medications were started or adjusted at 15.4% (43/280) of control visits compared to 20.4% (65/319) of intervention visits (p=.07).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">This computer application is easy to use and makes extensive patient-reported outcome data available at the point of care. Although no differences were seen in symptom trajectory, patients who had printed symptom summaries had improved communication during office visits and a trend towards more active symptom management during radiotherapy.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">9302957</journal-id>
<journal-id journal-id-type="pubmed-jr-id">8479</journal-id>
<journal-id journal-id-type="nlm-ta">Support Care Cancer</journal-id>
<journal-id journal-id-type="iso-abbrev">Support Care Cancer</journal-id>
<journal-title-group><journal-title>Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer</journal-title>
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<issn pub-type="ppub">0941-4355</issn>
<issn pub-type="epub">1433-7339</issn>
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<article-meta><article-id pub-id-type="pmid">26471280</article-id>
<article-id pub-id-type="pmc">4769076</article-id>
<article-id pub-id-type="doi">10.1007/s00520-015-2983-3</article-id>
<article-id pub-id-type="manuscript">NIHMS760785</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Computerized patient reported symptom assessment in radiotherapy: a pilot randomized, controlled trial</article-title>
</title-group>
<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Fromme</surname>
<given-names>Erik K.</given-names>
</name>
<degrees>MD, MCR, FAAHPM</degrees>
<aff id="A1">Mail Code: L586, Division of Hematology & Medical Oncology, OHSU Knight Cancer Institute, Oregon Health & Science University, Portland, OR 97239, Phone: 503-494-3152, Fax: 503-494-3257,<email>frommee@ohsu.edu</email>
</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Holliday</surname>
<given-names>Emma B.</given-names>
</name>
<degrees>MD</degrees>
<aff id="A2">Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd Unit 97, Houston, Texas 78240, Phone: 210-854-5399,<email>emmaholliday@gmail.com</email>
</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Nail</surname>
<given-names>Lillian M.</given-names>
</name>
<degrees>PhD, RN</degrees>
<aff id="A3">School of Nursing, Oregon Health & Science University</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Lyons</surname>
<given-names>Karen S.</given-names>
</name>
<degrees>PhD</degrees>
<aff id="A4">School of Nursing, Oregon Health & Science University</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Hribar</surname>
<given-names>Michelle R.</given-names>
</name>
<degrees>PhD</degrees>
<aff id="A5">Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University</aff>
</contrib>
<contrib contrib-type="author"><name><surname>Thomas</surname>
<given-names>Charles R.</given-names>
<suffix>Jr</suffix>
</name>
<degrees>MD</degrees>
<aff id="A6">Department of Radiation Medicine, OHSU Knight Cancer Institute, Oregon Health & Science University</aff>
</contrib>
</contrib-group>
<pub-date pub-type="nihms-submitted"><day>19</day>
<month>2</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub"><day>16</day>
<month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>4</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>4</month>
<year>2017</year>
</pub-date>
<volume>24</volume>
<issue>4</issue>
<fpage>1897</fpage>
<lpage>1906</lpage>
<pmc-comment>elocation-id from pubmed: 10.1007/s00520-015-2983-3</pmc-comment>
<abstract><sec id="S1"><title>Purpose</title>
<p id="P1">Computer-based, patient-reported symptom survey tools have been described for patients undergoing chemotherapy. We hypothesized that patients undergoing radiotherapy might also benefit, so we developed a computer application to acquire symptom ratings from patients and generate summaries for use at point of care office visits and conducted a randomized-controlled pilot trial to test its feasibility.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Subjects were randomized prior to beginning radiotherapy. Both control and intervention group subjects completed the computerized symptom assessment, but only for the intervention group were printed symptom summaries made available before each weekly office visit. Metrics compared included the Global Distress Index (GDI), concordance of patient-reported symptoms and symptoms discussed by the physician and numbers of new and/or adjusted symptom management medications prescribed.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">112 patients completed the study: 54 in the control and 58 in the intervention arms. There were no differences in GDI over time between the control and intervention groups. In the intervention group, more patient-reported symptoms were actually discussed in radiotherapy office visits: 46/202 vs. 19/230. A sensitivity analysis to account for within-subjects correlation yielded 23.2% vs. 10.3% (p=.03). Medications were started or adjusted at 15.4% (43/280) of control visits compared to 20.4% (65/319) of intervention visits (p=.07).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">This computer application is easy to use and makes extensive patient-reported outcome data available at the point of care. Although no differences were seen in symptom trajectory, patients who had printed symptom summaries had improved communication during office visits and a trend towards more active symptom management during radiotherapy.</p>
</sec>
</abstract>
<kwd-group><kwd>patient-reported outcomes</kwd>
<kwd>supportive care</kwd>
<kwd>radiation therapy</kwd>
<kwd>communication</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
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<tree><noCountry><name sortKey="Fromme, Erik K" sort="Fromme, Erik K" uniqKey="Fromme E" first="Erik K." last="Fromme">Erik K. Fromme</name>
<name sortKey="Holliday, Emma B" sort="Holliday, Emma B" uniqKey="Holliday E" first="Emma B." last="Holliday">Emma B. Holliday</name>
<name sortKey="Hribar, Michelle R" sort="Hribar, Michelle R" uniqKey="Hribar M" first="Michelle R." last="Hribar">Michelle R. Hribar</name>
<name sortKey="Lyons, Karen S" sort="Lyons, Karen S" uniqKey="Lyons K" first="Karen S." last="Lyons">Karen S. Lyons</name>
<name sortKey="Nail, Lillian M" sort="Nail, Lillian M" uniqKey="Nail L" first="Lillian M." last="Nail">Lillian M. Nail</name>
<name sortKey="Thomas, Charles R" sort="Thomas, Charles R" uniqKey="Thomas C" first="Charles R." last="Thomas">Charles R. Thomas</name>
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