Background
Advances in cancer management have been associated with an increased incidence of emergency presentations with disease- or treatment-related complications.
Objective
This study aimed to measure the ability of patients and members of their social network to complete checklists for complications of systemic treatment for cancer and examine the impact on patient-centered and health-economic outcomes.
Methods
A prospective interventional cohort study was performed to assess the impact of a smartphone app used by patients undergoing systemic cancer therapy and members of their network to monitor for common complications. The app was used by patients, a nominated “safety buddy,” and acute oncology services. The control group was made up of patients from the same institution. Measures were based on process (completion of checklists over 60 days), patient experience outcomes (Hospital Anxiety and Depression Scale and the General version of the Functional Assessment of Cancer Therapy at baseline, 1 month, and 2 months) and health-economic outcomes (usage of appointments in primary care and elective and unscheduled hospital admissions).
Results
At the conclusion of the study, 50 patients had completed 2882 checklists, and their 50 “safety buddies” had completed 318 checklists. Near daily usage was maintained over the 60-day study period. When compared to a cohort of 50 patients with matching disease profiles from the same institution, patients in the intervention group had comparable changes in Hospital Anxiety and Depression Scale and General version of the Functional Assessment of Cancer Therapy. Patients in the Intervention Group required a third (32 vs 97 nights) of the hospital days with overnight stay compared to patients in the Control Group, though the difference was not significant. The question, “I feel safer with the checklist,” received a mean score of 4.27 (SD 0.87) on a Likert scale (1-5) for patients and 4.55 (SD 0.65) for family and friends.
Conclusions
Patients undergoing treatment for cancer and their close contacts can complete checklists for common complications of systemic treatments and take an active role in systems supporting their own safety. A larger sample size will be needed to assess the impact on clinical outcomes and health economics.
BACKGROUND
Advances in cancer management have been associated with an increase in emergency presentations with disease or treatment related complications.
OBJECTIVE
To measure ability of patients and members of their social network to complete checklists for complications of systemic treatment for cancer and examine impact on patient-centred and health-economic outcomes.
METHODS
Prospective interventional cohort study of a smartphone application with common complications of cancer used by patients undergoing systemic treatment for cancer, a nominated ‘safety buddy’ and acute oncology services. Comparator group of patients from the same institution.
Measures were based on process (completion of checklists over 60 days), patient-centred outcomes included patient experience (Hospital Anxiety and Depression Scale (HADS) and the General version of the Functional Assessment of Cancer Therapy (FACT-G) at baseline, one month and two months) and health-economic outcomes (usage of appointments in primary care and elective and un-scheduled hospital admissions).
RESULTS
50 patients completed 2882 checklists and their 50 ‘safety buddies’ completed 318 checklists. Near daily usage was maintained over the 60-day study-period.
Compared to a cohort of 50 patients with matching disease profile from the same institution patients in the intervention group had comparable changes in HADS and FACT-G. Patients in the Intervention Group required a third (32 vs 97 nights) of hospital days with overnight stay compared to patients in the Control Group (n.s.).
The question ‘I feel safer with the checklist’ received a mean value of 4.27 (SD 0.87) on a Likert scale (1-5) for patients and mean 4.55 (SD 0.65) for family and friends.
CONCLUSIONS
Patients undergoing treatment for cancer and their close contacts are able to complete checklists for common complications of systemic treatments and take an active role in systems supporting their own safety. To assess impact on clinical outcomes and health-economics a larger sample size is required.
CLINICALTRIAL
Research Ethics Committee reference: 18/WA/0213
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