Patients were informed that no clinician would regularly monitor STAR reports between visits, and therefore should contact staff directly if severe of disabling symptoms occurred at home. Nonetheless, an automated alert system was integrated so that anytime a patient entered a symptom above a certain level of severity, an on-screen message appeared encouraging the patient to contact a clinician, and an e-mail warning was automatically sent to a designated nurse.
Although the study focused on the patient experience, its results suggest that self-reported data is a potentially valuable resource for clinicians as well. At each follow-up office visit, symptom reports were printed for clinical nurses. It was left to the discretion of patients and clinicians whether and how to incorporate STAR reports into their discussions.
All of the nurses who participated in the study understood the reports and felt this information was highly useful for clinical decisions, documentation, and discussions, said Ann Culkin, RN, a nurse on the Thoracic Oncology Service at MSKCC and a co-author of the study.
The nurses all noted that they had altered management based on patient-reported information and alerts from STAR, including recommending medication and lifestyle changes and arranging for additional physician consultations.
The authors concluded that online self-reporting is a feasible long-term strategy for monitoring toxicities during chemotherapy, even among very ill patients. However, explicit reminders to log in and clinician feedback on self-reported information are important to maintain patients continued interest and participation between visits.
These findings lay the groundwork for future research to assess whether patient self-reporting improves the efficiency and comprehensiveness of toxicity monitoring in clinical trials, and whether this approach can improve the quality of routine cancer care by expediting dete
|Contact: Esther Napolitano|
Memorial Sloan-Kettering Cancer Center