TY - JOUR
T1 - Quality of life after patient-initiated vs physician-initiated response to symptom monitoring
T2 - the SYMPRO-Lung trial
AU - Billingy, Nicole E.
AU - Tromp, Vashti N. M. F.
AU - Aaronson, Neil K.
AU - Hoek, Rianne J. A.
AU - Bogaard, Harm Jan
AU - Onwuteaka-Philipsen, Bregje D.
AU - van de Poll-Franse, Lonneke
AU - Hugtenburg, Jacqueline G.
AU - Belderbos, José
AU - Becker-Commissaris, Annemarie
AU - van den Hurk, Corina J. G.
AU - SYMPRO-Lung Consortium
AU - Walraven, Iris
N1 - Funding Information: This work was supported by Zorg Innovatiefonds (Innovatiefonds Zorgverzekeraars, Sparrenheuvel 16, Postbus 304, 3700 AH Zeist), Roche (Roche Nederland B.V., Beneluxlaan 2A, 3446 GR Woerden), and Stichting Kwaliteitsgelden Medisch Specialisten (SKMS, Mercatorlaan 1200, Postbus 20057, 3502 LB Utrecht). Publisher Copyright: © 2023 The Author(s). Published by Oxford University Press.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - BACKGROUND: Previous studies using patient-reported outcomes measures (PROMs) to monitor symptoms during and after (lung) cancer treatment used alerts that were sent to the health-care provider, although an approach in which patients receive alerts could be more clinically feasible. The primary aim of this study was to compare the effect of weekly PROM symptom monitoring via a reactive approach (patient receives alert) or active approach (health-care provider receives alert) with care as usual on health-related quality of life (HRQOL) at 15 weeks after start of treatment in lung cancer patients. METHODS: The SYMPRO-Lung trial is a multicenter randomized controlled trial using a stepped wedge design. Stage I-IV lung cancer patients in the reactive and active groups reported PROM symptoms weekly, which were linked to a common alerting algorithm. HRQOL was measured by the EORTC QLQ-C30 at baseline and after 15 weeks. Linear regression analyses and effect size estimates were used to assess mean QOL-C30 change scores between groups, accounting for confounding. RESULTS: A total of 515 patients were included (160 active group, 89 reactive group, 266 control group). No differences in HRQOL were observed between the reactive and active group (summary score: unstandardized beta [B] = 0.51, 95% confidence interval [CI] = -3.22 to 4.24, Cohen d effect size [ES] = 0.06; physical functioning: B = 0.25, 95% CI = -5.15 to 4.64, ES = 0.02). The combined intervention groups had statistically and clinically significantly better mean change scores on the summary score (B = 4.85, 95% CI = 1.96 to 7.73, ES = 0.57) and physical functioning (B = 7.00, 95% CI = 2.90 to 11.09, ES = 0.71) compared with the control group. CONCLUSIONS: Weekly PRO symptom monitoring statistically and clinically significantly improves HRQOL in lung cancer patients. The logistically less intensive, reactive approach may be a better fit for implementation.
AB - BACKGROUND: Previous studies using patient-reported outcomes measures (PROMs) to monitor symptoms during and after (lung) cancer treatment used alerts that were sent to the health-care provider, although an approach in which patients receive alerts could be more clinically feasible. The primary aim of this study was to compare the effect of weekly PROM symptom monitoring via a reactive approach (patient receives alert) or active approach (health-care provider receives alert) with care as usual on health-related quality of life (HRQOL) at 15 weeks after start of treatment in lung cancer patients. METHODS: The SYMPRO-Lung trial is a multicenter randomized controlled trial using a stepped wedge design. Stage I-IV lung cancer patients in the reactive and active groups reported PROM symptoms weekly, which were linked to a common alerting algorithm. HRQOL was measured by the EORTC QLQ-C30 at baseline and after 15 weeks. Linear regression analyses and effect size estimates were used to assess mean QOL-C30 change scores between groups, accounting for confounding. RESULTS: A total of 515 patients were included (160 active group, 89 reactive group, 266 control group). No differences in HRQOL were observed between the reactive and active group (summary score: unstandardized beta [B] = 0.51, 95% confidence interval [CI] = -3.22 to 4.24, Cohen d effect size [ES] = 0.06; physical functioning: B = 0.25, 95% CI = -5.15 to 4.64, ES = 0.02). The combined intervention groups had statistically and clinically significantly better mean change scores on the summary score (B = 4.85, 95% CI = 1.96 to 7.73, ES = 0.57) and physical functioning (B = 7.00, 95% CI = 2.90 to 11.09, ES = 0.71) compared with the control group. CONCLUSIONS: Weekly PRO symptom monitoring statistically and clinically significantly improves HRQOL in lung cancer patients. The logistically less intensive, reactive approach may be a better fit for implementation.
UR - http://www.scopus.com/inward/record.url?scp=85179140800&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/jnci/djad159
DO - https://doi.org/10.1093/jnci/djad159
M3 - Article
C2 - 37603720
SN - 0027-8874
VL - 115
SP - 1515
EP - 1525
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 12
ER -