Research published today (22nd July) in the BMJ has found that remote 24-hour monitoring for cancer patients receiving chemotherapy helps to better manage side effects and improve quality of life.

Previous research on remote monitoring during chemotherapy has shown benefits, but is largely based on short trials from a single site or country, making it difficult to draw wider conclusions.

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To address this evidence gap, a team of international researchers set out to evaluate the effects of remote monitoring of chemotherapy related side effects on symptom burden, supportive care needs, anxiety, work limitations, and quality of life.

Patients completed a daily symptom questionnaire and were provided with self-care advice 

The research was based on the results of 829 cancer patients aged 18 years or older. Each patient had been diagnosed with either breast cancer, colorectal cancer, Hodgkin’s disease, or non-Hodgkin’s lymphoma, and were receiving chemotherapy at 12 cancer centres in Austria, Greece, Norway, the Republic of Ireland and the UK.

Patients were randomly allocated to 24-hour symptom monitoring via the Advanced Symptom Management System (ASyMS) (intervention group) or standard care at their cancer centre (control group) over six cycles of chemotherapy.

Intervention patients completed a daily symptom questionnaire on a handheld ASyMS device; this generated alerts to hospital clinicians if action was needed. Patients were also provided with self-care advice with information on how to manage their symptoms themselves.

The results of the study found promising evidence that remote monitoring can support patients to manage their symptoms and reduce stress levels. The study also found: 

  • For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards.
  • Analysis indicated significant reductions in favour of ASyMS for psychological and physical symptoms and for level of distress associated with each symptom.
  • Health related quality of life scores were higher in the intervention group across all cycles, whereas average scores for anxiety were lower.
  • Measures of cancer patients’ confidence and ability to engage in their care were also higher in the intervention group, and most supportive care needs were lower, including sexual related needs and physical and daily living needs.
  • Other areas of supportive care needs and work limitations were similar in both groups, and the safety of ASyMS was satisfactory.

Remote monitoring systems will be vital for future services, say researchers

The researchers say the results show that remote monitoring can provide a safe, secure, and “real time” system that optimises symptom management and supports patients to remain at home, which is particularly relevant in the context of the Covid-19 pandemic.

This is the largest trial to date of remote monitoring of symptoms during chemotherapy for cancers being treated with curative intent, and its robust design avoided many limitations of previous studies, say the researchers.

They acknowledge some limitations, including technical problems and the fact that most participants had breast cancer and were female, suggesting a larger study is warranted for patients with other types of cancer.

Nevertheless, they say their findings suggest that an evidence based remote monitoring intervention, such as ASyMS, has potential for implementation into routine care to make a meaningful difference to people with cancer.

Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the Covid-19 pandemic, they add.