Remote Symptom Monitoring Transitions Cancer Patients From Hospital to Home

Remote symptom monitoring can help cancer patients transition from the hospital to home, according to research published in JCO Oncology Practice.

Researchers found that a remote monitoring intervention was warranted in discharged cancer patients, as they had a high symptom burden. Patients reported being satisfied with the intervention, and there was a numeric — but not statistically significant — decrease in readmission rates with the intervention.

The intervention was designed to provide remote symptom monitoring for 10 days after hospital discharge and intervene to manage symptoms if necessary. The intervention allowed patients to complete electronic symptom assessments through the patient portal. The assessments were available from 9 am to 5 pm every day. Patients who developed symptoms after hours were told to call the symptom triage number.

The assessments included branching logic for reported symptoms to ask patients additional questions about the extent, severity, and interference of those symptoms; an avatar patients could use to demonstrate where pain was occurring; and a text box where patients could report additional symptom information.

Moderate symptoms generated a yellow alert, and severe symptoms generated a red alert, both of which were sent to the clinical team. A patient’s primary nurse responded to symptom alerts during the week, and a team of nurses monitored symptoms over the weekend.

Patients also received educational materials about their symptoms via the patient portal. The materials provided information on evidence-based symptom management.

Results of Remote Symptom Monitoring

The researchers tested the remote symptom monitoring intervention in 1857 cancer patients who had a total of 2257 discharges from the hospital. The median age of the patients was 63 years, and 54% were women. The most common cancers were gastrointestinal (25%), thoracic (19%), and breast (13%) cancers.

A total of 1489 patients (66%) completed at least 1 symptom assessment. Of those patients, 45.5% generated a severe symptom alert, and 30.4% generated a moderate symptom alert as their highest alert level.

Of the 630 patients who completed the patient engagement survey, most reported being satisfied with the intervention. Overall, 88% of patients said the time and effort needed to participate in the intervention was worth it, 87% said the intervention made them feel more connected to the care team, 82% said the intervention made them feel more confident about managing their symptoms, and 75% said the intervention might decrease visits to urgent care or the emergency department.

The researchers observed numeric, but not statistically significant, decreases in readmission rates among patients who were offered the intervention or who completed at least 1 symptom assessment, compared to patients who were not offered the intervention.

The researchers compared 269 gastrointestinal cancer patients who were offered the intervention to 180 gastrointestinal cancer patients who were not. The 30-day readmission rate was 30.5% in the intervention cohort and 33.3% in the control cohort (P =.49). The readmission rate was 27.5% for patients who completed at least 1 symptom assessment, compared to 33.3% for the control cohort (P =.22).

“The intervention was associated with high patient satisfaction but will require further refinement and evaluation to increase its impact on 30-day readmission,” the researchers concluded.

Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

This article originally appeared on Cancer Therapy Advisor