Efficacy and feasibility of OncoSmart, a tool for remote detection and monitoring chemoterapy-related adverse events in metastatic colorectal cancer patients: a pilot retrospective study. (Preprint)
BACKGROUND In metastatic colorectal cancer (mCRC) treatment-related health symptoms may have a strong impact on patient’s quality of life (QoL). It has been shown that a considerable number of health care providers underestimates symptom intensity. In this context, the systematic collection of electronic patient-reported outcomes (ePROs) has been demonstrated to be a valid, reliable, feasible and precise approach to tabulating symptomatic toxicities and to detect symptoms missed by clinicians. OBJECTIVE We aimed to evaluate feasibility as well as patients’ acceptance of remote technology system to detect and monitoring chemotherapy-related adverse events in metastatic colorectal cancer outpatients. METHODS We enrolled 8 mCRC outpatients who received an oncological treatment. A wearable device (smart watch) allowing automatic vitals measurement (blood pressure, heart rate, oxygen saturation, respiratory rate, pedometer and sleeping monitor) has been provided to all patients. Moreover, two mobile applications have been developed: the first one to monitor vital measurements recorded by the wearable device, the second one to identify treatment-related toxicities and QoL parameters using a 30-items questionnaire (some taken from EORTCQLQ-C30 and others composed by the investigators). Clinicians filled the electronic health records (EHR) at each visit with symptoms reported by patients, physical examination and any treatment modifications. RESULTS a total of 8 patients were enrolled, 2 women (25%) and 6 men (75%); median age was 54 years (range 35-69). Compliance was 77%. Overall concordance between ePRO and symptoms detected by clinicians was 80%; in 15% of cases of electronic patient-reported outcomes (ePROs) included symptoms missed during the visit, while in 5% of cases clinicians reported toxicities not recorded by patients. Regarding the symptoms that led to treatment modifications and/or suspension, the concordance between ePROs and clinician’s evaluation during the visit was 100%. CONCLUSIONS In our pilot experience this type of ePROs is feasible and well tolerated, showing high compliance (80%), and allowing identification of toxicities missed by clinicians in 15% of cases. These data suggest that the integration of ePROs with EHR may improve the management of cancer patients. These strategies should be prioritized to optimize active oncological treatments and supportive care in order to improve patient’s QoL and reduce inappropriate hospitalization.