- Electronic patient self-Reporting of Adverse-events: Patient Information and advice (eRAPID) is an online system for patients to report symptoms that provides automated severity-dependent advice (self-management or alerts for hospital contact).
- eRAPID improves symptom control early during chemotherapy.
- New models of cancer care can reduce hospital attendance.
Why this matters
- Physical symptoms during cancer treatment are common and affect quality of life (QoL).
- There is increasing evidence that patient self-reporting of symptoms improves care.
- The COVID-19 pandemic complicates acute care and emergency department utilization.
- The phase 3 trial enrolled 508 patients that started chemotherapy for colorectal, breast, and gynecological cancers at Leeds Cancer Centre.
- Patients were randomized (1:1) to Usual Care (UC) or the eRAPID, consisting of weekly online reporting of symptoms for 18 weeks.
- The primary outcome was symptom control (FACT-PWB score).
- Funding: UK National Institute for Health Research.
- 3314 online reports were completed (median per patient 14.0); the median weekly completion rate was 72.2%.
- High patient adherence was associated with clinicians’ use of the data and high baseline FACT-PWB score.
- Emergency alerts were activated in 29 cases (0.9%); self-management advice was provided in 2714 cases (81.9%).
- FACT-PWB scores did not significantly differ between arms at 18 weeks.
- Significantly higher FACT-PWB scores were observed at 6 and 12 weeks in the eRAPID arm.
- eRAPID patients reported better self-efficacy and QOL (EQ5D-VAS) at 12 and 18 weeks.
- Subgroup analysis found better FACT-PWB scores in the nonmetastatic group.
- Single-center trial.
“The current pandemic has accelerated a shift towards alternative care models to reduce COVID-19 exposure and preserve health care resources. The eRAPID trial provides a new promising model for alternative care delivery. We can view the current pandemic as a catalyst to rapidly evolve and scientifically validate innovative home-based and remote models of care,” said Lynne I. Wagner, Professor, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston Salem, NC, USA.