Correlation Between Remote Symptom Reporting by Caregivers and Adverse Clinical Outcomes: Mixed Methods Study.

Area of Science:

• Oncology
• Digital Health
• Patient-Reported Outcomes

Background:

• Timely collection of patient-reported outcomes (PROs) is crucial for improving cancer patient survival and reducing healthcare utilization.
• Limited data exists on the predictive value of informal caregivers reporting outcomes using clinical assessment tools.

Purpose of the Study:

• To evaluate caregiver and patient adherence to a scheduled electronic PRO data collection regimen.
• To determine if PROs collected electronically are associated with future clinical events in cancer patients.

Main Methods:

• Developed two iPhone applications for PRO data collection: one for patients and one for caregivers.
• Enrolled 52 patient-caregiver dyads in a 4-week nonrandomized study, collecting PROs via apps.
• Utilized electronic health records for clinical event data and logistic/quasi-Poisson regression for analysis.

Main Results:

• High adherence rates observed: 97% for Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) and 98% for Patient-Reported Outcomes Measurement Information System (PROMIS) surveys.
• Caregiver-reported PRO-CTCAE data significantly associated with patient hospitalizations, emergency visits, severe adverse events, dose reductions, and hospice referrals.
• Caregiver-reported PROMIS data linked to hospice referrals; patient-reported PROMIS data associated with mortality and other clinical events.

Conclusions:

• Smartphone app-based PRO collection by both patients and caregivers is feasible and adhered to.
• Caregiver-reported PRO-CTCAE data shows promise in predicting patient clinical events, potentially reducing patient burden in data collection.
• This method may offer early indicators of worsening symptom severity in cancer patients.