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AMTRA: a multicentered experience of a web-based monitoring and tailored toxicity management system for cancer patients

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Abstract

Background

Technology-based interventions are increasingly being introduced in routine clinical cancer care. There is a need for reliable systems to monitor treatment-related toxicity in a standardized manner. Such electronic tools bridge the gap in providing quality home-based monitoring.

Methods

From July 2017 to December 2017, we performed a multicentered, non-randomized prospective cohort analysis with patients who were receiving routine chemotherapy for various solid tumors, using a web-based patient-reported toxicity registration, management, and intervention system called AMTRA (ambulatory Monitoring of cancer Therapy using an interactive Application) linked to the homecare nursing organization Remedus®. Twelve common toxicities plus pain and two biometrics could be registered daily or more frequently as required. These were processed centrally to generate tailored advice for lesser symptoms or a phone call from a dedicated nurse in case of severe or prolonged toxicity. A compliance tool to monitor oral therapies was incorporated in the system.

Results

One hundred sixty-eight patients (92%) were enrolled, with 31,514 registrations analyzed. One hundred eight patients reported severe toxicity (> 1461 registrations), resulting in 102 clinical interventions ranging from self-management advice, supplemental consultations to hospitalizations. Compliance to oral chemotherapy was high using AMTRA with a median of 98.7% (95 confidence interval (CI) [93.5–100.0%]). Seventy-nine percent of patients stated that the availability of AMTRA self-reports was useful in communication with the care provider, while 75% felt more in control while managing their treatment.

Conclusions

The application of an interactive PRO-system in routine symptom management of cancer patients allowed standardized documentation of toxicities and recorded a high compliance with oral treatment. It allows for rapid interaction for toxicities and cancer-related symptoms experienced at home.

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Acknowledgments

We thank the study participants and the many physicians and nurses who reviewed, responded, and interacted to symptom reports of our patients. We also thank this study’s clinical research associates and data managers, Lesley De Backer in particular and staff, who supported the AMTRA patient self-report web platform at Remedus®. We also thank Ella Roelants for her statistical evaluations and calculations.

Funding

This study represents independent research funded by a Federal Government of Belgium in the program for Mobile Health initiatives. The views expressed are those of the authors and not necessarily of the Belgian Federal Government, or the Department of Health.

Author information

Authors and Affiliations

  1. Department of Oncology, Multidisciplinary Oncological Center Antwerp, MOCA, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium

    Marika Rasschaert, Sven De Keersmaeker, Kathleen Vandenborne & Marc Peeters

  2. Department of Medical Oncology, AZ Maria Middelares, Ghent, Belgium

    Christof Vulsteke & Stefanie Dias

  3. Department of Molecular Imaging, Pathology, Radiotherapy & Oncology (MIPRO); Center for Oncological Research (CORE), Antwerp University, Antwerp, Belgium

    Christof Vulsteke

  4. Department of Oncology and Hematology, Grand Hôpital de Charleroi (GHDC)-site Notre Dame, Charleroi, Belgium

    Vincent Verschaeve

  5. Medical Oncology, CHU UCL, UCLouvain Site St-Elisabeth’s Hospital, Namur, Belgium

    Peter Vuylsteke

  6. Remedus Bvba, Aartselaar, Belgium

    Ilse Van Brussel & Jo Ravelingien

  7. Unit of Gynecologic Oncology, Department of Obstetrics & Gynecology, University Hospital Antwerp, Antwerp, Belgium

    Peter Van Dam

  8. Department of Oncology, Monash Health and Monash University, Melbourne, Victoria, Australia

    Eva Segelov

Authors
  1. Marika Rasschaert
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  2. Christof Vulsteke
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  3. Sven De Keersmaeker
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  4. Kathleen Vandenborne
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  6. Vincent Verschaeve
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  7. Peter Vuylsteke
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  8. Ilse Van Brussel
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  9. Jo Ravelingien
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  10. Peter Van Dam
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  11. Eva Segelov
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  12. Marc Peeters
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Corresponding author

Correspondence to Marika Rasschaert.

Ethics declarations

The study was conducted in accordance with the Declaration of Helsinki and approved by participating hospital institutional ethics committees. Patient registries and epidemiological data were captured in accordance with General Data Protection Regulation (GDPR) (EU) 2016/679 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data.

Conflict of interest

The following represents disclosure information provided by authors of this manuscript.

Ilse van Brussel:

Employment: Remedus

Jo Ravelingien:

Employment: Remedus

Marc Peeters:

Advisor for Remedus

No other potential conflicts of interest were reported.

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Rasschaert, M., Vulsteke, C., De Keersmaeker, S. et al. AMTRA: a multicentered experience of a web-based monitoring and tailored toxicity management system for cancer patients. Support Care Cancer 29, 859–867 (2021). https://doi.org/10.1007/s00520-020-05550-6

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