The Patient-Centered Outcomes Research Institute (PCORI) has awarded Ethan Basch, MD, MSc, a $5.45 million grant to support research into whether there are clinical benefits of having people with cancer self-report their symptoms while undergoing treatment. The project, titled Electronic Patient Reporting of Symptoms during Outpatient Cancer Treatment: A US National Randomized Controlled Trial and will run for a span of 60 months.
Basch, Director of University of North Carolina (UNC) Lineberger Comprehensive Cancer Center’s Cancer Outcomes Research Program, is a national leader in the study of patient-reported outcomes and technologies to measure the impact of interventions on patients’ experiences. He will conduct the research in conjunction with the Alliance for Clinical Trials in Oncology Foundation.
Basch will team up with Carevive Systems for the use of their 24/7 telephone triage protocols and self-management care plans, which will be used by triage nurses in the half of the 50 targeted US centers randomized to the intervention arm in this randomized clinical trial.
“I’m excited to have Carevive Systems as a part of this project,” Basch stated. “Carevive’s involvement in this study will be key to providing the most up to date and evidence-based pathways for symptom management. The data we collect will help us to understand if collecting patient-reported outcomes from people with cancer, responding to them in a standardized, evidence-based manner, can improve communication, quality of care, and clinical outcomes.”
The national trial will investigate whether integrating patient-reported symptoms into care management can improve the patient’s quality of care and quality of life, and measure the impact of patient self-reporting on the healthcare delivery system.
“Patients with metastatic cancer frequently experience symptoms that cause distress, disability, and lead to urgent care visits., These symptoms often go unrecognized and unaddressed by clinicians even though there are many interventions that can provide relief,” stated Basch, who is also a professor at the UNC School of Medicine Division of Hematology and Oncology. “Sometimes this happens because patients did not have the opportunity to discuss symptoms at an office visit or the symptoms occurred between visits.”
Basch theorizes that enabling patients to report their own symptoms electronically at regular intervals could address this issue. A patient reporting severe symptoms could trigger clinicians to respond with interventions ranging from advice to prescriptions or triage for evaluation. Prior studies have found most patients are willing to self-report symptoms during cancer care, and clinicians find this information valuable. Preliminary data suggests this approach leads to better patient quality of life, reduces emergency room and hospital visits, and may lengthen survival.
“We are thrilled to collaborate with Dr. Basch and the core scientific team on this timely project, which will leverage Carevive’s symptom management platform to support patients as well as their triage nurses when responding to alerts of severe and/or worsening symptoms, “Dr. Carrie Stricker, PhD, RN, Chief Clinical Officer of Carevive, stated. “Nurses will use the guideline-based telephone triage protocols developed in concert with hundreds of experts to target improvement in symptom and quality of life outcomes, as well as reductions in unnecessary health care utilization. “Improving patient outcomes is central to Carevive’s mission, and the outcomes targeted in this study are particularly timely given the rapid movement to value-based cancer payments models, including CMS’s Oncology Care Model that began July 1st, which emphasize patient-centered care and reducing costly ED visits and hospitalizations”, added Dr. Stricker.
The researchers have developed a randomized trial to better understand the impact of patients self-reporting symptoms. In the intervention arm, patients are given options of a secured internet site or an automated telephone system to regularly report 12 common symptoms. Email alerts will be sent to nurses when patients report severe or worsening symptoms. Nurses and patients will be provided with evidence-based symptom management recommendations. The trial’s control arm will not include symptom self-reporting, but nurses and patients will be provided with symptom management recommendations.
The outcomes being tracked include physical function, quality of life, emergency room/hospital visits, survival, and perspectives about relative benefits and burdens from patients, clinicians, and national organizations.
For a full project summary visit the PCORI website here.
About PCORI
The Patient-Centered Outcomes Research Institute (PCORI), an independent nonprofit, nongovernmental organization located in Washington, DC. Their mandate is to improve the quality and relevance of evidence available to help patients, caregivers, clinicians, employers, insurers, and policy makers make informed health decisions. Specifically, they fund comparative clinical effectiveness research, or CER, as well as support work that will improve the methods used to conduct such studies
About Carevive Systems
Carevive Systems is a technology and services company that builds workflow and patient engagement tools in collaboration with thousands of clinical and health service research experts to improve clinical outcomes and lower costs. Validated, best-practice, patient-centered care delivery models and intelligence from their proprietary data drives design and continuous refinement of their cloud-based tools and services.