Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity
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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.
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.
Seven clinical sites in the UK; five specialist cancer centres and two local district hospitals.
One hundred and twelve people with breast, lung or colorectal cancer receiving outpatient chemotherapy.
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).
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).
The study demonstrates that ASyMS© can support the management of symptoms in patients with lung, breast and colorectal cancer receiving chemotherapy.
KeywordsChemotherapy Symptoms Technology Assessment
The authors would like to thank Stirling University Research Enterprise for funding this study and would like to extend a special thank you and note of appreciation to all the patients and health professionals who participated.
- 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.Department of Health (2007) Cancer reform strategy—executive summary.Google Scholar
- 3.The Scottish Government (2007) Better health, better care. Scottish Government, Edinburgh. Available at http://www.scotland.gov.uk/Topics/Health/Action-Plan
- 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
- 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.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.Scottish Executive Health Department (2005a) Delivering for Health Edinburgh. Scottish Executive Health Department, EdinburghGoogle Scholar
- 14.Scottish Executive Health Department (2005b) National service framework for Service Change Edinburgh. Scottish Executive Health Department, EdinburghGoogle Scholar
- 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
- 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.The National Cancer Institute (2003) The common toxicity adverse events criteria. National Cancer Institute, BethesdaGoogle Scholar
- 28.McCloone P (2004) Carstairs scores for Scottish postcode sectors from the 2001 Census. Public Health Research Unit, University of Glasgow, GlasgowGoogle Scholar
- 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
- 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
- 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.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.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.ISD Online. Cancer incidence, mortality and survival data. http://www.isdscotland.org/cancer. Accessed 2007
- 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.Northern Ireland Cancer Registry. Cancer Incidence and Mortality. http://www.qub.ac.uk/research-centres/nicr/Data/OnlineStatistics/#d.en.26094 Accessed 2007
- 43.Diggle PJ, Heagerty PJ, Liang KY, Zeger SL (2002) Analysis of longitudinal data, 2nd edn. Oxford University Press, OxfordGoogle Scholar