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.
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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
Department of Health (2007) Cancer reform strategy—executive summary.
The Scottish Government (2007) Better health, better care. Scottish Government, Edinburgh. Available at http://www.scotland.gov.uk/Topics/Health/Action-Plan
Park VJ, Trovato JA (2004) Frequency of nausea and vomiting after chemotherapy. Am J Health Syst Pharm 61:722–723
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):83–87
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
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
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
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
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
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-#
Scottish Executive Health Department (2005a) Delivering for Health Edinburgh. Scottish Executive Health Department, Edinburgh
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):851–858
Scottish Executive Health Department (2005b) National service framework for Service Change Edinburgh. Scottish Executive Health Department, Edinburgh
Roine R, Ohinmaa A, Hailey D (2001) Assessing telemedicine: a systematic review of the literature. CMAJ 165(6):765–771
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
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):467–474
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
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
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
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
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)
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
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
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
The National Cancer Institute (2003) The common toxicity adverse events criteria. National Cancer Institute, Bethesda
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
McCloone P (2004) Carstairs scores for Scottish postcode sectors from the 2001 Census. Public Health Research Unit, University of Glasgow, Glasgow
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):4–12
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
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
Eilers J, Berger AM, Peterson MC (1988) Development, testing, and application of the oral assessment. Oncol Nurs Forum 15:325–330
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
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, India
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):380–386
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)
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)
Office for National Statistics (2006) Cancer statistics registrations: registrations of cancer diagnosed in 2004, England. Series MB1 no. 35. Office for National Statistics, London
ISD Online. Cancer incidence, mortality and survival data. http://www.isdscotland.org/cancer. Accessed 2007
Welsh Cancer Intelligence and Surveillance Unit (2007) Cancer incidence in Wales. Available at http://www.wales.nhs.uk/sites3/home.cfm?OrgID=242
Northern Ireland Cancer Registry. Cancer Incidence and Mortality. http://www.qub.ac.uk/research-centres/nicr/Data/OnlineStatistics/#d.en.26094 Accessed 2007
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
Diggle PJ, Heagerty PJ, Liang KY, Zeger SL (2002) Analysis of longitudinal data, 2nd edn. Oxford University Press, Oxford
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.
Trial registration ISRCTN 67370244
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Kearney, N., McCann, L., Norrie, J. et al. Evaluation of a mobile phone-based, advanced symptom management system (ASyMS©) in the management of chemotherapy-related toxicity. Support Care Cancer 17, 437–444 (2009). https://doi.org/10.1007/s00520-008-0515-0