ASCO 2020 – eRAPID, a new model of care that improves physical well-being during chemotherapy


  • Elena Riboldi — Agenzia Zoe
  • Oncology Conference reports
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Single-center trial.

Expert commentary

“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.