Abstract
Purpose
Patients undergoing a hematopoietic stem cell transplantation (HCT) have varied symptoms during their hospitalization. This study examined whether daily symptom reporting (with electronic patient-reported outcomes [PROs]) in an inpatient bone marrow transplant clinic reduced symptom burden on post-transplant days +7, +10, and +14.
Methods
A prospective, single-institution 1:1 pilot randomized, two-arm study recruited HCT patients. HCT inpatients (N = 76) reported daily on 16 common symptoms using the PRO version of the Common Terminology for Adverse Events (PRO-CTCAE). Fisher’s exact test was used to examine differences in the proportion of patients reporting individual symptoms. Multivariable linear regression modeling was used to examine group differences in peak symptom burden, while controlling for symptom burden at baseline, age, comorbidity, and transplantation type (autologous or allogeneic).
Results
HCT patients receiving the PRO intervention also experienced lower peak symptom burden (average of 16 symptoms) at days +7, +10, and +14 (10.4 vs 14.5, p = 0.03).
Conclusions
Daily use of electronic symptom reporting to nurses in an inpatient bone marrow transplant clinic reduced peak symptom burden and improved individual symptoms during the 2 weeks post-transplant. A multi-site trial is warranted to demonstrate the generalizability, efficacy, and value of this intervention.
Trial registration
ClinicalTrials.gov identifier: NCT 02574897
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Funding
This study was financially supported by a 5K12CA120780-07 (Bryant), University Cancer Research Fund UL1RR025747 (Bryant and Wood), and T32 NR00709 (Hirschey). The University of North Carolina’s Patient-Reported Outcomes Core is supported in part by the University Cancer Research Fund and the Lineberger Comprehensive Cancer Center core grant (P30-CA-016086).
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Dr. Bill Wood has funding support from Pfizer, Genetech, Koneksa Health, and Best Doctors. I do not have a financial relationship with the organization that sponsored the research.
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Bryant, A.L., Coffman, E., Phillips, B. et al. Pilot randomized trial of an electronic symptom monitoring and reporting intervention for hospitalized adults undergoing hematopoietic stem cell transplantation. Support Care Cancer 28, 1223–1231 (2020). https://doi.org/10.1007/s00520-019-04932-9
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DOI: https://doi.org/10.1007/s00520-019-04932-9