A trial has found that cancer patients can benefit from regular online symptom reporting combined with a computer algorithm to manage symptoms and improve wellbeing during chemotherapy. The eRAPID trial was the first to offer automated advice in addition to regular self-reporting, and one of only a few to focus mainly on early-stage patients whose treatment aims to cure their cancer.
Building on previous research that used technology to record quality of life measures, clinicians identified it would be beneficial to measure patients self-reported symptoms. The inclusion of a clinical algorithm to provide automated advice to patients was devised by patient advocates and oncology professionals to reassure patients that any mild symptoms they are experiencing are typical and that they can take simple steps to alleviate them. It also acted as a safety net to ensure severe symptoms were not missed.
During the trial development, researchers presented and discussed the idea with the NCRI Psychosocial Oncology and Survivorship Group (now part of the NCRI Living With and Beyond Cancer Group) which identified a similar project, eSMART. The group established that while there was overlap in the interventions, there were notable differences to justify both projects.
Cancer patients can experience a range of symptoms, which can be caused by the cancer itself, other conditions, or are side effects of chemotherapy and other treatments. These are sometimes life-threatening and require emergency hospitalisation.
Symptoms can significantly lower patients’ quality of life, and better monitoring and management can improve treatment delivery and reduce patients’ physical distress.
Funded by the National Institute for Health Research (NIHR) and led by Prof Galina Velikova (medical oncologist University of Leeds and the Leeds Cancer centre), the eRAPID trial set out to establish whether symptom control could be improved using automated advice to improve patients’ wellbeing.
Over five-hundred patients with predominantly early-stage colorectal, breast or gynaecological cancers took part in the eRAPID trial, developed by the University of Leeds, which allowed them to report online symptoms from home on mobile devices and receive instant advice on whether to self-manage or seek medical attention.
Patients reported better symptom control and physical wellbeing in the early weeks of treatment, with the system preventing symptom deterioration in about 9% of patients after 12 weeks. The results were published in the Journal of Clinical Oncology.
This approach offers an alternative care delivery model during curative chemotherapy, supporting cancer patients experiencing mild to moderate symptoms without increasing hospital workload. The Covid-19 pandemic has triggered a shift to using remote technology-enabled care. This study provides further evidence for the benefits of using online symptom monitoring as a feasible strategy to support cancer patients care.