title: A randomized trial of weekly symptom telemonitoring in advanced lung cancer.
abstract: BACKGROUND
  Lung cancer patients experience multiple, simultaneous symptoms related to their disease and treatment that impair functioning and health-related quality of life (HRQL). Computer technology can reduce barriers to nonsystematic, infrequent symptom assessment and potentially contribute to improved patient care.
  
  
  OBJECTIVE
  To evaluate the efficacy of technology-based symptom monitoring and reporting in reducing symptom burden in patients with advanced lung cancer.
  
  
  METHODS
  This was a prospective, multisite, randomized controlled trial. Two hundred fifty-three patients were enrolled at three sites and randomized to monitoring and reporting (MR) or monitoring alone (MA). Patients completed questionnaires at baseline, 3, 6, 9, and 12 weeks and symptom surveys via interactive voice response weekly for 12 weeks. MR patients' clinically significant symptom scores generated an e-mail alert to the site nurse for management. The primary endpoint was overall symptom burden; secondary endpoints included HRQL, treatment satisfaction, symptom management barriers, and self-efficacy.
  
  
  RESULTS
  This randomized controlled trial failed to demonstrate efficacy of symptom monitoring and reporting in reducing symptom burden compared with monitoring alone in lung cancer. HRQL declined over 12 weeks in both groups (P < 0.006 to P < 0.025); at week 12, treatment satisfaction was higher in MA than MR patients (P < 0.012, P < 0.027). Adherence to weekly calls was good (82%) and patient satisfaction was high.
  
  
  CONCLUSIONS
  Feasibility of using a technology-based system for systematic symptom monitoring in advanced lung cancer patients was demonstrated. Future research should focus on identifying patients most likely to benefit and other patient, provider, and health system factors likely to contribute to the system's success.
authors.affiliation: Northwestern University, Chicago, Illinois, USA. Electronic address: s-yount@northwestern.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Yount
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Nan
authors.initials: N
authors.lastname: Rothrock
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Bass
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Beaumont
authors.affiliation: Rush University Medical Center, Chicago, Illinois, USA.
authors.forename: Deborah
authors.initials: D
authors.lastname: Pach
authors.affiliation: John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lad
authors.affiliation: Northwestern Medical Faculty Foundation, Chicago, Illinois, USA.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Patel
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Corona
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Weiland
authors.affiliation: NORC at the University of Chicago, Chicago, Illinois, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Del Ciello
authors.affiliation: Northwestern University, Chicago, Illinois, USA.
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D020377:Self Efficacy; D055752:Small Cell Lung Carcinoma / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D017216:Telemedicine / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Lung cancer; health information technology; randomized controlled trial; symptoms; telemonitoring