CHEMOTHERAPY patients whose symptoms were tracked remotely had significantly lower anxiety and better quality of life compared to people left to alert doctors themselves about potentially worrying side effects.
Researchers at Strathclyde University say that digital technology which monitors people at home on a daily basis could make a "meaningful difference" to people with cancer.
Their findings, published today in the BMJ, follow a three-year trial involving 829 patients with potentially curable cancers at centres in Austria, Greece, Norway, Ireland and England.
Half of participants were allocated to the ASyMS group, a digital tracker system which provides 24-hour real-time monitoring and management of chemotherapy toxicity.
These patients were asked to complete a daily questionnaire rating symptoms such as nausea, vomiting, constipation, and pain.
They were also asked to submit daily body temperature readings using a digital thermometer.
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This symptom data was automatically evaluated by the ASyMS algorithm which, if necessary, would generate amber or red alerts direct to hospital clinicians.
Amber indicated mild to moderate symptoms which could be halted with early intervention, while red signalled a chemotherapy emergency such as neutropenic sepsis - a potentially deadly complication caused when a type of white blood falls to dangerously low levels.
Clinicians, who were allocated dedicated handsets, were expected to act on red alerts within 30 minutes.
Of the 3456 red alerts triggered during the trial, 85 per cent were responded to within the target time, and 1,207 resulted in a referral to the hospital oncology department.
However, most - more than 1600 - could be alleviated with self-care advice provided by the app.
Of the 3746 amber alerts, which clinicians had eight hours to respond to, 95% met the target time.
The system was devised to counter problems in the management of chemotherapy and its side effects.
The authors note that "under-treatment of symptoms results in poorer adherence to treatment, impaired health related quality of life, increased health service use, and mortality", adding: "Current symptom assessment mechanisms rely on patients recognising that symptoms are severe enough to warrant reporting.
"Uncertainty, delayed reporting, and inability to access 24 hour services frequently lead to toxicities not being recognised sufficiently quickly, placing patients’ safety at risk."
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They also noted that anxiety is "the most common psychological symptom after diagnosis of cancer".
There were six deaths in total - three in the AsyMS group and three in the control - and the number of unplanned hospital admissions were similar at 120 and 109 respectively.
A higher number of neutropenic sepsis cases were detected in AsyMS patients, however, than the control group - 125 versus 71 - but this was "was expected as greater identification was the intervention's intent".
Chief investigator Roma Maguire, professor of digital health and care at Strathclyde University, said the results demonstrated that there were no safety issues with the technology but said larger studies would be need to show a reduction in mortality and hospitalisation.
"With the ASyMS system designed to pick up symptoms early in their trajectory including life threatening infections, it is plausible that we could see these effects in the future as a result of using the system," she said.
However, the study did find "significant reductions" in anxiety and physical symptoms in the AsyMS group, as well as a notable improvement in quality of life and less need for support in their daily lives.
"I think you can't underestimate that," said Prof Maguire.
"That is hugely significant when it comes to the patient experience, because if someone has a good quality of life that can manifest in lots ways, including in cancer survivorship."
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