Long-Term Toxicity Monitoring via Electronic Patient-Reported Outcomes in Patients Receiving Chemotherapy

作者：Ethan Basch, Alexia E. Iasonos, Allison Barz Leahy, Ann Culkin, Mark G. Kris, David R. Artz, Paul Fearn, John Speakman, Rena Farquhar, Howard I. Scher, Mary S. McCabe, Deborah Schrag · 发表于：Journal of Clinical Oncology · 年份：2007 · DOI：10.1200/jco.2007.11.2243 · 被引用次数：210 · 研究领域：Cancer survivorship and care、Electronic Health Records Systems、Pharmacovigilance and Adverse Drug Reactions

PURPOSE: In cancer treatment trials, clinicians traditionally report patient toxicity symptoms. Alternatively, patients could provide this information directly. PATIENTS AND METHODS: The Common Terminology Criteria for Adverse Events (CTCAE) is the mandated instrument for tracking patient toxicity symptoms in National Cancer Institute (NCI)-sponsored cancer treatment trials. We adapted CTCAE symptom items into patient language and uploaded these to an online platform. Lung cancer outpatients receiving chemotherapy were invited to self-report selected symptoms at visits via waiting area computers or optional home access. Symptom reports were printed for nurses at visits, but no instructions were given with regard to use of this information. RESULTS: From June 2005 through March 2006, 125 patients were invited to participate, and 107 chose to enroll. Mean length of participation was 42 weeks (range, 1 to 71 weeks), by which time 35% died. The average number of clinic visits was 12 (range, 1 to 40 visits). At each consecutive visit, most patients (mean, 78%) logged in without significant attrition. Reasons for failure to log in included having no reminder and having inadequate time. Although 76% of enrollees had home computers, only 15% self-reported from home. Satisfaction with the system was high (90%), but only 51% felt communication was improved. All participating nurses understood the reports and felt this information was useful for clinical decisions, documentation, and di...