{"id":20431,"date":"2021-08-24T04:58:00","date_gmt":"2021-08-23T20:58:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=20431"},"modified":"2021-08-24T05:37:40","modified_gmt":"2021-08-23T21:37:40","slug":"bmj%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%82%bf%e7%98%a4%e5%8c%96%e7%96%97%e6%9c%9f%e9%97%b4%e5%ae%9e%e6%97%b6%e8%bf%9c%e7%a8%8b%e7%97%87%e7%8a%b6%e7%9b%91%e6%b5%8b%ef%bc%9a%e6%ac%a7","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=20431","title":{"rendered":"[BMJ\u53d1\u8868\u8bba\u6587]\uff1a\u80bf\u7624\u5316\u7597\u671f\u95f4\u5b9e\u65f6\u8fdc\u7a0b\u75c7\u72b6\u76d1\u6d4b\uff1a\u6b27\u6d32\u591a\u4e2d\u5fc3\u968f\u673a\u5bf9\u7167\u8bd5\u9a8c"},"content":{"rendered":"\n

Research<\/strong><\/p>\n\n\n\n

Real time remote symptom monitoring during chemotherapy for cancer: European multicentre randomised controlled trial (eSMART)<\/h1>\n\n\n\n

Roma Maguire<\/a>, Lisa McCann, Grigorios Kotronoulas,\u00a0et al<\/h3>\n\n\n\n

BMJ<\/em>\u00a02021;\u00a0374\u00a0doi:\u00a0https:\/\/doi.org\/10.1136\/bmj.n1647<\/a>\u00a0(Published 22 July 2021)<\/h3>\n\n\n\n

Cite this as:\u00a0BMJ<\/em>\u00a02021;374:n1647<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

Objective<\/strong> To evaluate effects of remote monitoring of adjuvant chemotherapy related side effects via the Advanced Symptom Management System (ASyMS) on symptom burden, quality of life, supportive care needs, anxiety, self-efficacy, and work limitations.<\/p>\n\n\n\n

Design<\/strong> Multicentre, repeated measures, parallel group, evaluator masked, stratified randomised controlled trial.<\/p>\n\n\n\n

Setting<\/strong> Twelve cancer centres in Austria, Greece, Norway, Republic of Ireland, and UK.<\/p>\n\n\n\n

Participants<\/strong> 829 patients with non-metastatic breast cancer, colorectal cancer, Hodgkin\u2019s disease, or non-Hodgkin\u2019s lymphoma receiving first line adjuvant chemotherapy or chemotherapy for the first time in five years.<\/p>\n\n\n\n

Intervention<\/strong> Patients were randomised to ASyMS (intervention; n=415) or standard care (control; n=414) over six cycles of chemotherapy.<\/p>\n\n\n\n

Main outcome measures<\/strong> The primary outcome was symptom burden (Memorial Symptom Assessment Scale; MSAS). Secondary outcomes were health related quality of life (Functional Assessment of Cancer Therapy\u2014General; FACT-G), Supportive Care Needs Survey Short-Form (SCNS-SF34), State-Trait Anxiety Inventory\u2014Revised (STAI-R), Communication and Attitudinal Self-Efficacy scale for cancer (CASE-Cancer), and work limitations questionnaire (WLQ).<\/p>\n\n\n\n

Results<\/strong> For the intervention group, symptom burden remained at pre-chemotherapy treatment levels, whereas controls reported an increase from cycle 1 onwards (least squares absolute mean difference \u22120.15, 95% confidence interval \u22120.19 to \u22120.12; P<0.001; Cohen\u2019s D effect size=0.5). Analysis of MSAS sub-domains indicated significant reductions in favour of ASyMS for global distress index (\u22120.21, \u22120.27 to \u22120.16; P<0.001), psychological symptoms (\u22120.16, \u22120.23 to \u22120.10; P<0.001), and physical symptoms (\u22120.21, \u22120.26 to \u22120.17; P<0.001). FACT-G scores were higher in the intervention group across all cycles (mean difference 4.06, 95% confidence interval 2.65 to 5.46; P<0.001), whereas mean scores for STAI-R trait (\u22121.15, \u22121.90 to \u22120.41; P=0.003) and STAI-R state anxiety (\u22121.13, \u22122.06 to \u22120.20; P=0.02) were lower. CASE-Cancer scores were higher in the intervention group (mean difference 0.81, 0.19 to 1.43; P=0.01), and most SCNS-SF34 domains were lower, including sexuality needs (\u22121.56, \u22123.11 to \u22120.01; P<0.05), patient care and support needs (\u22121.74, \u22123.31 to \u22120.16; P=0.03), and physical and daily living needs (\u22122.8, \u22125.0 to \u22120.6; P=0.01). Other SCNS-SF34 domains and WLQ were not significantly different. Safety of ASyMS was satisfactory. Neutropenic events were higher in the intervention group.<\/p>\n\n\n\n

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Conclusions<\/strong> Significant reduction in symptom burden supports the use of ASyMS for remote symptom monitoring in cancer care. A \u201cmedium\u201d Cohen\u2019s effect size of 0.5 showed a sizable, positive clinical effect of ASyMS on patients\u2019 symptom experiences. Remote monitoring systems will be vital for future services, particularly with blended models of care delivery arising from the covid-19 pandemic.<\/p>\n\n\n\n

Trial registration<\/strong> Clinicaltrials.gov NCT02356081<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Research Real time remote symptom monitoring during che […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20431"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20431"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20431\/revisions"}],"predecessor-version":[{"id":20432,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/20431\/revisions\/20432"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20431"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20431"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20431"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}