title: Feasibility of long-term patient self-reporting of toxicities from home via the Internet during routine chemotherapy.
abstract: OBJECTIVE
  Patient-reported outcomes are increasingly used in routine outpatient cancer care to guide clinical decisions and enhance communication. Prior evidence suggests good patient compliance with reporting at scheduled clinic visits, but there is limited evidence about compliance with long-term longitudinal reporting between visits.
  
  
  METHODS
  Patients receiving chemotherapy for lung, gynecologic, genitourinary, or breast cancer at a tertiary cancer center, with access to a home computer and prior e-mail experience, were asked to self-report seven symptomatic toxicities via the Web between visits. E-mail reminders were sent to participants weekly; patient-reported high-grade toxicities triggered e-mail alerts to nurses; printed reports were provided to oncologists at visits. A priori threshold criteria were set to determine if this data collection approach merited further development based on monthly (≥ 75% participants reporting at least once per month on average) and weekly compliance rates (60% at least once per week).
  
  
  RESULTS
  Between September 2006 and November 2010, 286 patients were enrolled (64% were women; 88% were white; median age, 58 years). Mean follow-up was 34 weeks (range, 2 to 214). On average, monthly compliance was 83%, and weekly compliance was 62%, without attrition until the month before death. Greater compliance was associated with older age and higher education but not with performance status. Compliance was greatest during the initial 12 weeks. Symptomatic illness and technical problems were rarely barriers to compliance.
  
  
  CONCLUSIONS
  Monthly compliance with home Web reporting was high, but weekly compliance was lower, warranting strategies to enhance compliance in routine care settings.
authors.affiliation: Weill Cornell Medical College, New York, NY, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Judson
authors.forename: Antonia V
authors.initials: AV
authors.lastname: Bennett
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Rogak
authors.forename: Laura
authors.initials: L
authors.lastname: Sit
authors.forename: Allison
authors.initials: A
authors.lastname: Barz
authors.forename: Mark G
authors.initials: MG
authors.lastname: Kris
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Hudis
authors.forename: Howard I
authors.initials: HI
authors.lastname: Scher
authors.forename: Paul
authors.initials: P
authors.lastname: Sabattini
authors.forename: Deborah
authors.initials: D
authors.lastname: Schrag
authors.forename: Ethan
authors.initials: E
authors.lastname: Basch
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D002173:Cancer Care Facilities; D015331:Cohort Studies; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000209:etiology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D020407:Internet / Q000706:statistics & numerical data*; D008134:Long-Term Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000188:drug therapy* / Q000473:pathology; D010349:Patient Compliance / Q000706:statistics & numerical data; D012189:Retrospective Studies; D057566:Self Report; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States