Supportive Care in Cancer

, Volume 17, Issue 4, pp 437–444 | Cite as

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

  • N. Kearney
  • L. McCann
  • J. Norrie
  • L. Taylor
  • P. Gray
  • M. McGee-Lennon
  • M. Sage
  • M. Miller
  • R. Maguire
Original Article

Abstract

Objectives

To evaluate the impact of a mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©) on the incidence, severity and distress of six chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand–foot syndrome and diarrhoea) in patients with lung, breast or colorectal cancer.

Design

A two group (intervention and control) by five time points (baseline, pre-cycle 2, pre-cycle 3, pre-cycle 4 and pre-cycle 5) randomised controlled trial.

Setting

Seven clinical sites in the UK; five specialist cancer centres and two local district hospitals.

Participants

One hundred and twelve people with breast, lung or colorectal cancer receiving outpatient chemotherapy.

Interventions

A mobile phone-based, remote monitoring, advanced symptom management system (ASyMS©).

Main outcome measures

Chemotherapy-related morbidity of six common chemotherapy-related symptoms (nausea, vomiting, fatigue, mucositis, hand–foot syndrome and diarrhoea).

Results

There were significantly higher reports of fatigue in the control group compared to the intervention group (odds ratio = 2.29, 95%CI = 1.04 to 5.05, P = 0.040) and reports of hand–foot syndrome were on average lower in the control group (odds ratio control/intervention = 0.39, 95%CI = 0.17 to 0.92, P = 0.031).

Conclusion

The study demonstrates that ASyMS© can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy.

Keywords

Chemotherapy Symptoms Technology Assessment 

References

  1. 1.
    Scottish Executive (2001) Cancer scenarios: an aid to planning cancer services in Scotland in the next decade. Available at http://www.scotland.gov.uk/Resource/Doc/158659/0043045.pdf
  2. 2.
    Department of Health (2007) Cancer reform strategy—executive summary.Google Scholar
  3. 3.
    The Scottish Government (2007) Better health, better care. Scottish Government, Edinburgh. Available at http://www.scotland.gov.uk/Topics/Health/Action-Plan
  4. 4.
    Park VJ, Trovato JA (2004) Frequency of nausea and vomiting after chemotherapy. Am J Health Syst Pharm 61:722–723PubMedGoogle Scholar
  5. 5.
    Dranitsaris G, Maroun J, Shah A (2005) Estimating the cost of illness in colorectal cancer patients who were hospitalized for severe chemotherapy-induced diarrhoea. Can J Gastroenterol 19(2):83–87PubMedGoogle Scholar
  6. 6.
    Polednak AP (2004) Surveillance for hospitalizations with infection-related diagnoses after chemotherapy among breast cancer patients diagnosed before age 65. Chemotherapy 50(4):157–161 doi:10.1159/000080688 PubMedCrossRefGoogle Scholar
  7. 7.
    Du XL, Osborne C, Goodwin JS (2002) Population-based assessment of hospitalizations for toxicity from chemotherapy in older women with breast cancer. J Clin Oncol 20(24):4636–4642 doi:10.1200/JCO.2002.05.088 PubMedCrossRefGoogle Scholar
  8. 8.
    Chen-Hardee S, Chrischilles EA, Voelker MD, Brooks JM, Scott S, Link BK et al (2006) Population-based assessment of hospitalizations for neutropenia from chemotherapy in older adults with non-Hodgkin's lymphoma (United States). Cancer Causes Control 17(5):647–654 doi:10.1007/s10552-005-0502-4 PubMedCrossRefGoogle Scholar
  9. 9.
    Kuderer NM, Dale DC, Crawford J, Cosler LE, Lyman GH (2006) Mortality, morbidity, and cost associated with febrile neutropenia in adult cancer patients. Cancer 106(10):2258–2266 doi:10.1002/cncr.21847 PubMedCrossRefGoogle Scholar
  10. 10.
    National Institute for Health (2002) Management of cancer symptoms: pain, depression and fatigue. Available at http://www.ncbi.nlm.nih.gov/books/bv.fcgi?rid=hstat1a.chapter.5
  11. 11.
    Cleeland CS, Cleeland LM, Dar R, Rinehardt LC (1986) Factors influencing physician management of cancer pain. Cancer 58(3):796–800 doi:10.1002/1097-0142(19860801)58:3<796::AID-CNCR2820580331>3.0.CO;2-# PubMedCrossRefGoogle Scholar
  12. 12.
    Scottish Executive Health Department (2005a) Delivering for Health Edinburgh. Scottish Executive Health Department, EdinburghGoogle Scholar
  13. 13.
    McCaughan EM, Thompson KA (2000) Information needs of cancer patients receiving chemotherapy at a day-case unit in Northern Ireland. J Clin Nurs 9(6):851–858CrossRefGoogle Scholar
  14. 14.
    Scottish Executive Health Department (2005b) National service framework for Service Change Edinburgh. Scottish Executive Health Department, EdinburghGoogle Scholar
  15. 15.
    Roine R, Ohinmaa A, Hailey D (2001) Assessing telemedicine: a systematic review of the literature. CMAJ 165(6):765–771PubMedGoogle Scholar
  16. 16.
    May C, Mort M, Williams T, Mair F, Gask L (2003) Health technology assessment in its local contexts: studies of telehealthcare. Soc Sci Med 57:697–710 doi:10.1016/S0277-9536(02)00419-7 PubMedCrossRefGoogle Scholar
  17. 17.
    Barnett TE, Chumbler NR, Vogel WB, Beyth RJ, Qin H, Kobb R (2006) The effectiveness of a care coordination home telehealth program for veterans with diabetes mellitus: a 2-year follow-up. Am J Manag Care 12(8):467–474PubMedGoogle Scholar
  18. 18.
    Biermann E, Dietrich W, Rihl J, Standl E (2002) Are there time and cost savings by using telemanagement for patients on intensified insulin therapy? A randomised, controlled trial. Comput Methods Programs Biomed 69(2):137–146 doi:10.1016/S0169-2607(02)00037-8 PubMedCrossRefGoogle Scholar
  19. 19.
    Chumbler NR, Neugaard B, Kobb R, Ryan P, Qin H, Joo Y (2005) Evaluation of a care coordination/home-telehealth program for veterans with diabetes: health services utilization and health-related quality of life. Eval Health Prof 28(4):464–478 doi:10.1177/0163278705281079 PubMedCrossRefGoogle Scholar
  20. 20.
    Louis AA, Turner T, Gretton M, Baksh A, Cleland JG (2003) A systematic review of telemonitoring for the management of heart failure. Eur J Heart Fail 5(5):583–590 doi:10.1016/S1388-9842(03)00160-0 PubMedCrossRefGoogle Scholar
  21. 21.
    Rasmussen LM, Phanareth K, Nolte H, Backer V (2005) Internet-based monitoring of asthma: a long-term, randomized clinical study of 300 asthmatic subjects. J Allergy Clin Immunol 115(6):1137–1142 doi:10.1016/j.jaci.2005.03.030 PubMedCrossRefGoogle Scholar
  22. 22.
    Maguire R, Miller M, Sage M, Norrie J, McCann L, Taylor L et al (2005) Results of a UK based pilot study of a mobile phone based advanced symptom management system (ASyMS) in the remote monitoring of chemotherapy related toxicity. Clin Eff Nurs 9(3–4):202–210 (Sept–Dec)CrossRefGoogle Scholar
  23. 23.
    Mooney KH, Beck SL, Friedman RH, Farzanfar R (2002) Telephone-linked care for cancer symptom monitoring: a pilot study. Cancer Pract 10(3):147–154 doi:10.1046/j.1523-5394.2002.103006.x PubMedCrossRefGoogle Scholar
  24. 24.
    Ryan D, Cobern W, Wheeler J, Price D, Tarassenko L (2005) Mobile phone technology in the management of asthma. J Telemed Telecare 11:43–46 doi:10.1258/1357633054461714 PubMedCrossRefGoogle Scholar
  25. 25.
    Brown V, Sitzia J, Richardson A, Hughes J, Hannon H, Oakley C (2001) The development of the Chemotherapy Symptom Assessment Scale (C-SAS): a scale for the routine clinical assessment of the symptom experiences of patients receiving cytotoxic chemotherapy. Int J Nurs Stud 38(5):497–510 doi:10.1016/S0020-7489(00)00106-1 PubMedCrossRefGoogle Scholar
  26. 26.
    The National Cancer Institute (2003) The common toxicity adverse events criteria. National Cancer Institute, BethesdaGoogle Scholar
  27. 27.
    Kearney N, Kidd L, Miller M, Sage M, Khorrami J, McGee M et al (2006) Utilising handheld computers to monitor and support patients receiving chemotherapy: results of a UK-based feasibility study. Support Cancer Care 14(7):742–752 doi:10.1007/s00520-005-0002-9 CrossRefGoogle Scholar
  28. 28.
    McCloone P (2004) Carstairs scores for Scottish postcode sectors from the 2001 Census. Public Health Research Unit, University of Glasgow, GlasgowGoogle Scholar
  29. 29.
    Vogelzang NJ, Breitbart W, Cella D, Curt GA, Groopman JE, Horning SA et al (1997) Patient, caregiver and oncologist perceptions of cancer-related fatigue: results of a tripart assessment study. Semin Hematol 3(2):4–12Google Scholar
  30. 30.
    Ahlberg K, Ekman T, Gaston-Johansson F, Mock V (2003) Assessment and management of cancer-related fatigue in adults. Lancet 362:640–650 doi:10.1016/S0140-6736(03)14186-4 PubMedCrossRefGoogle Scholar
  31. 31.
    Webster-Gandy JD, How C, Harrold K (2007) Palmar-plantar erythrodysesthesia (PPE): a literature review with commentary on experience in a cancer care. Eur J Oncol Nurs 11(3):238–246 doi:10.1016/j.ejon.2006.10.004 PubMedCrossRefGoogle Scholar
  32. 32.
    Eilers J, Berger AM, Peterson MC (1988) Development, testing, and application of the oral assessment. Oncol Nurs Forum 15:325–330PubMedGoogle Scholar
  33. 33.
    Mueller BA, Millheim ET, Farrington EA et al (1995) Mucositis management practices for hospitalised patients: national survey results. J Pain Symptom Manage 10(7):510–520 doi:10.1016/0885-3924(95)00064-6 PubMedCrossRefGoogle Scholar
  34. 34.
    Gibson F, Aldiss S, McCann L, Maguire R, Miller M, Kearney N (2007) Using a mobile phone based advanced symptom management system to monitor and manage chemotherapy related toxicity. Pediatric Blood and Cancer 49(4):408 (Abstract 0.035 oral). Proceedings of the 39th Annual Conference of the International Society of Paediatric Oncology (SIOP), Mumbai, IndiaGoogle Scholar
  35. 35.
    Maguire R, McCann L, Miller M, Kearney N (2008) Nurses perceptions and experiences of using a mobile phone based Advanced Symptom Management System (ASyMS©) to monitor and manage chemotherapy related toxicity. Eur J Oncol Nurs 12(4):380–386PubMedCrossRefGoogle Scholar
  36. 36.
    McCann L, Maguire R, Miller M, Kearney N (2008) Patients perceptions and experiences of using a mobile phone bases Advanced Symptom Management System (ASyMS©) to monitor and manage chemotherapy related toxicity. Eur J Cancer Care (Engl) (in press)Google Scholar
  37. 37.
    McCall K, Keen JN, Farrer K, Maguire R, McCann L, Johnston B, McGill M, Sage M, Kearney N (2008) Health professionals and patients perceptions of the use of a remote monitoring system (ASyMS©) in the recording and management of symptoms in patients receiving palliative care at home. Int J Palliat Nurs (in press)Google Scholar
  38. 38.
    Office for National Statistics (2006) Cancer statistics registrations: registrations of cancer diagnosed in 2004, England. Series MB1 no. 35. Office for National Statistics, LondonGoogle Scholar
  39. 39.
    ISD Online. Cancer incidence, mortality and survival data. http://www.isdscotland.org/cancer. Accessed 2007
  40. 40.
    Welsh Cancer Intelligence and Surveillance Unit (2007) Cancer incidence in Wales. Available at http://www.wales.nhs.uk/sites3/home.cfm?OrgID=242
  41. 41.
    Northern Ireland Cancer Registry. Cancer Incidence and Mortality. http://www.qub.ac.uk/research-centres/nicr/Data/OnlineStatistics/#d.en.26094 Accessed 2007
  42. 42.
    Scott NW, McPherson GC, Ramsay CR, Campbell MK (2002) The method of minimisation for allocation to clinical trials. Control Clin Trials 23:662–674 doi:10.1016/S0197-2456(02)00242-8 PubMedCrossRefGoogle Scholar
  43. 43.
    Diggle PJ, Heagerty PJ, Liang KY, Zeger SL (2002) Analysis of longitudinal data, 2nd edn. Oxford University Press, OxfordGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • N. Kearney
    • 1
  • L. McCann
    • 1
  • J. Norrie
    • 2
  • L. Taylor
    • 1
  • P. Gray
    • 3
  • M. McGee-Lennon
    • 3
  • M. Sage
    • 4
  • M. Miller
    • 1
  • R. Maguire
    • 1
  1. 1.Cancer Care Research Centre, Department of Nursing and MidwiferyUniversity of StirlingStirlingUK
  2. 2.Centre for Healthcare Randomised Trials, Health Services Research UnitUniversity of AberdeenAberdeenUK
  3. 3.Department of Computing ScienceUniversity of GlasgowGlasgowUK
  4. 4.Kelvin Connect LtdHillington Park Innovation CentreGlasgowUK

Personalised recommendations