Could ePRO improve holistic cancer care?
29th January 2019 by Alex Teckkam
Electronic patient-reported outcomes (ePRO) have the potential to improve many facets of cancer patient treatment and survivorship. ePRO may allow quicker identification and treatment of medically significant symptoms and so minimise patient anxiety regarding relapse.1 It could also enhance patient-healthcare professional (HCP) communication to facilitate better treatment decisions and potentially improve the quality of life for patients.1,2
It is hoped that ePRO can achieve these improvements and help HCPs deliver better holistic care for patients.
A group from Leeds comprised of patients, staff and IT specialists, developed a new ePRO technology called “eRapid”, Electronic patient self-Reporting of Adverse-events (AE): Patient Information and aDvice. This is a secure, integrated electronic platform for patients to report AE which can be accessed from any web-enabled device, including tablets and smartphones.3
When a patient accesses eRAPID and enters details of low and moderate AE, advice on self-management is provided. Whereas, entry of a severe AE triggers advice that the patient should immediately contact their hospital. When severe AE are reported the patient’s HCP also receives an email notification.3 This rapid escalation of concerning symptoms could lead to more positive outcomes for patients. eRAPID will be examined via randomised controlled trials in patients receiving systemic treatment for colorectal, breast and gynaecological cancers, so that the value of this new digital technology can be determined.3
In respect to cancer survivorship, ePRO can minimise patient anxiety regarding relapse. Depending on the severity of the symptoms recorded by the patient, reassurance or advice regarding immediate action is provided.1 Another feature of the ePRO system is that it tracks patient mental health so that support can be provided if necessary.1 However, the success of this function depends on mental health services being available.1 It is hoped that greater attention to patient symptoms via ePRO, rather than just clinical recurrence of cancer, will improve the quality of life for cancer patients.4
Innovative ways of tracking patient symptoms can be of particular importance for certain cancer types. For example, relapse of aggressive lymphoma is better detected through symptom monitoring than routine blood tests.4 Therefore, regularly tracking these signs could be invaluable. Additionally, ePRO prompts patients to periodically report symptoms and book tests when needed.4 This allows quicker identification of medically significant symptoms1 and can improve patient-HCP communication, so more informed treatment decisions can be made.2
We hope that the e-PRO will continue to advance, helping to support patients during diagnosis, treatment and survival. With the expansion of effective treatment options for cancer patients it’s important that cancer treatment is holistic and patient individuality during and after treatment is considered throughout the patient journey.
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1- Heathcote L. C., Goldberg D. S., Eccleston C. et al. (2019) Digitally enabled patient-reported outcome measures in cancer care – Authors' reply. Lancet Oncol. 20(1), e3.
2- eRAPID., (2019). eRAPID Aims and Objectives [online]. [Viewed 24 January 2019]. Available from: https://pogweb.org/index.php/erapid/
3- Holch P., Warrington L., Bamforth L. C. A., et al. (2017) Development of an integrated electronic platform for patient self-report and management of adverse events during cancer treatment. Ann Oncol. 28(9), 2305–311.
4- Linder, O. C., Velikova, G. and Stark, D. P. (2019) Digitally enabled patient-reported outcome measures in cancer care. Lancet Oncol. 20(1), e2. 5- Gourd E. (2018) Routine blood tests have low utility in lymphoma surveillance. Lancet Oncol. 19(9), e442.
By Rivka Marks-Maran