Online tool for monitoring adverse events in patients with cancer during treatment (eRAPID): field testing in a clinical setting

Abstract

ObjectivesElectronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID) is an online system developed to support patient care during cancer treatment by improving the detection and management of treatment-related symptoms. Patients can complete symptom reports from home and receive severity-based self-management advice, including notifications to contact the hospital for severe symptoms. Patient data are available in electronic records for staff to review. Prior to the commencement of a randomised controlled trial (RCT), field testing of the intervention was undertaken to troubleshoot practical issues with intervention integration in clinical practice.DesignObservational clinical field testing.SettingMedical oncology breast service in a UK cancer centre.Participants12 patients receiving chemotherapy for early breast cancer and 10 health professionals (oncologists and specialist nurses).InterventionPatients were asked to use the eRAPID intervention and complete weekly online symptom reports during four cycles of chemotherapy. Clinical staff were invited to access and use patient data in clinical assessments.AnalysisDescriptive data on the frequency of online symptom report completion and severe symptom notifications were collated. Verbal and written feedback was collected from patients and staff and semistructured interviews were conducted to explore patient experiences. Interviews were transcribed and analysed thematically.ResultsThe testing ran from January 2014 to March 2014. Feedback from patients and staff was largely positive. Patients described eRAPID as ‘reassuring’ and ‘comforting’ and valued the tailored management advice. Several changes were made to refine eRAPID. In particular, improvement of the clinical notification, patient reminder systems and changes to patient and staff training.ConclusionsThe field testing generated valuable results used to guide refinement of eRAPID prior to formal intervention evaluation. Feedback indicated that eRAPID has the potential to improve patients’ self-efficacy, knowledge and confidence with managing symptoms during treatment. A large-scale RCT is underway with data collection due to finish in October 2018.

A real-time electronic symptom monitoring system for patients after discharge following surgery: a pilot study in cancer-related surgery

“…Symptom selfreport items originated or were informed by established, validated measures used widely in studies of cancer patients. Participant refusal rates are in keeping with other similar pilot studies [63] and studies of surgical patients [64][65][66] and likely reflect in part how unwell participants were feeling soon after major cancer surgery when they were approached about recruitment to the study. It is possible that patients who declined to participate may have been feeling more unwell than those who took part.…”

Patient experiences of an electronic PRO tailored feedback system for symptom management following upper gastrointestinal cancer surgery

“…However, by providing relevant and reassuring guidance to participants about when it was appropriate to contact HCPs, or when symptoms could instead be self-managed, the ePRO system enabled participants to make informed decisions. Similar themes of reassurance and increasing confidence in decisionmaking have been reported by participants using the eRA-PID system during chemotherapy treatment [36].…”

Remote symptom monitoring integrated into electronic health records: A systematic review

“…Table 2 shows that patient data capture technologies included 1 smartphone application available for Android phones 20 and 2 online patient portals tethered to the EHR, 25 , 27 , 30 but the majority of systems used websites that could be accessed from the patient’s home computer or any web-based device. 21–23 , 26 , 28 , 29 , 31 …”