Telephone‐Linked Care for Cancer Symptom Monitoring

Abstract

The TLC system has the potential to improve dramatically symptom monitoring and symptom care of patients with cancer at home. Further testing is needed, but the TLC chemotherapy monitoring application shows promise for improving supportive-care service delivery for cancer patients. In its initial test, the TLC chemotherapy monitoring application has been shown to be highly acceptable to patients, able to generate useful symptom data, and able to generate faxed alerts to healthcare providers, thus improving communication about poorly controlled symptoms.

Symptom Cluster Research: Conceptual, Design, Measurement, and Analysis Issues

“…Innovative approaches to measurement using technology can provide more frequent assessments. 31 This issue will be discussed in greater detail later in this paper.…”

“…This approach was used in a study of Telephone-Linked Care in which patients use an interactive voice response telephone communication system to provide daily reports of nine symptoms. 31 This funneling approach to symptom measurement has the advantage of decreasing respondent burden. The disadvantage is an unbalanced data structure as there are no specific data collected when the symptom does not occur, i.e., the participant responds "no" to a screening question.…”

“…For each symptom identified by the patient, specific dimensions were measured including severity, distress, duration, and relief provided. 31 As the process of measurement becomes more complicated in the case of symptom clusters, it is important to consider the use of technology. Touch-screen computers, hand-held devices, and automated telephone reporting could allow for more frequent and more accurate reporting of symptoms than a paper questionnaire or symptom journal.…”

“…Touch-screen computers, hand-held devices, and automated telephone reporting could allow for more frequent and more accurate reporting of symptoms than a paper questionnaire or symptom journal. In addition to the example provided of Telephone-Linked Care using interactive voice response, 31 others have set up computer kiosks to assess symptoms in clinical settings 43 or used palm pilots to gather frequent symptom data using a technique called ecological momentary assessment. 44 Measurement devices such as the use of actigraphy, a small watch-like motion detector, can be used to reliably measure length and patterns of sleep/rest.…”

Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity

“…Many of these technologies are patient centred and appear to complement current transitions within health care models, shifting care from the acute hospital setting to the home environment, with technology being used to rationalise and integrate services, where appropriate, based on patient need. This type of technology has principally been used in the home care of patients with long term conditions such as chronic heart failure, asthma and diabetes [17][18][19][20][21] and to a lesser extent in patients with cancer [22][23] . Improvements in patient outcomes have been reported 22,24 as have reductions in the rate of hospitalisations, emergency room visits and increased cost savings 20 .…”