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TOPLINE:

Remote symptom monitoring (RSM) using electronic patient-reported outcomes reduced hospitalizations by 19% at 3 months and 13% at 6 months in patients with cancer receiving systemic treatment. Implementation of RSM showed consistent benefits across diverse patient populations, including Black patients and those in rural or disadvantaged areas.

METHODOLOGY:

• Previous randomized clinical trials demonstrated that RSM improved symptom burden, quality of life, and time of receiving treatment while reducing healthcare utilization. Despite such successful trials, implementation of electronic patient-reported outcomes in routine care has been limited, with few practices achieving successful integration.
• This new nonrandomized controlled trial with a hybrid type 2 implementation-effectiveness design included 1392 patients with cancer receiving RSM from 2021 to 2024, who were compared with 4557 historical controls from 2017 to 2021 at two Alabama-based academic institutions.
• Patients receiving chemotherapy, targeted therapy, or immunotherapy were enrolled in RSM, with a median age of 61 years, including 67% women, 27% Black patients, and 19% from rural areas.
• Analysis focused on healthcare utilization outcomes at 3 and 6 months after RSM enrollment, including intensive care unit admissions, hospitalizations, and emergency department visits.
• Researchers used adjusted modified Poisson models to estimate relative risk and 95% CI of healthcare utilization, with additional stratified analyses by patient race, residence, neighborhood deprivation, insurance type, and comorbid conditions.

TAKEAWAY:

• Hospitalizations among RSM patients were significantly lower than controls at both 3 months (relative risk [RR], 0.81; 95% CI, 0.73-0.91) and 6 months (RR, 0.87; 95% CI, 0.80-0.96).
• Emergency department visits showed no significant differences between groups at 3 months (RR, 1.02; 95% CI, 0.89-1.16) and 6 months (RR, 1.03; 95% CI, 0.92-1.15).
• Intensive care unit admissions demonstrated no significant differences between RSM and control populations at 3 months (RR, 0.82; 95% CI, 0.59-1.13) and 6 months (RR, 0.83; 95% CI, 0.65-1.06).
• According to the researchers, similar patterns in relative risk were observed across patient subgroups, including those stratified by race, rurality, and socioeconomic status.

IN PRACTICE:

“In this nonrandomized controlled trial, RSM implementation was associated with reduced risk of hospitalizations for patients with cancer, supporting the need to expand implementation nationally…,” wrote the authors of the study. “Findings were observed in a diverse patient population, supporting broad applicability and highlighting the potential for this [Enhancing Oncology Model–required] practice transformation activity to impact value in cancer care delivery.”

SOURCE:

The study was led by Gabrielle B. Rocque, MD, MSPH, University of Alabama at Birmingham. It was published online on May 13 in JAMA Network Open.

LIMITATIONS:

According to the authors, not all eligible patients participated in the RSM program due to incomplete roll-out and patient declination, potentially introducing selection bias. The study population included few Hispanic patients and other subpopulations who may have unique language and cultural needs. Additionally, the analysis was limited to two academic centers and may not fully represent experiences in community practice settings. The researchers noted that electronic medical record–based analyses were limited in capturing utilization outside the participating centers, and outcomes for patients who declined or had incomplete survey participation were not assessed.

DISCLOSURES:

The study was supported by grant No. IR01NR019058 from the National Institute of Nursing Research. Rocque disclosed receiving grants from Pfizer and Daiichi Sankyo and personal fees from Gilead and being employed by Atlas Oncology Partners, outside the submitted work. Additional disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.