Step count and symptom severity during cancer treatment using the Symptom Care at Home digital platform

P atients undergoing systemic cancer therapy still experience significant symptom burden. Electronic patient-reported outcomes (ePRO) monitoring and follow-up of symptoms has improved suffering, but limited work has explored combined subjective and objective measures. This secondary analysis explored the relationship between oncology symptoms and step count using the Symptom Care at Home (SCH) digital monitoring platform.

Participants reported 11 disease and treatment symptoms: fatigue, trouble sleeping, nausea and vomiting, pain, numbness or tingling, depressed mood, feeling nervous or anxious, trouble breathing, diarrhea, sore mouth, and trouble thinking or concentrating via ePRO and independently reported step count via Garmin activity monitors. Analysis included descriptive statistics and linear mixed-effect models to examine the relationship between symptom burden and step count.

Of participants who provided Garmin activity monitors (n = 339), 18-5 (54%) reported ePRO symptoms and step counts. A mean 76.56 days of step count and 56 days of ePRO were reported. The mean step count was 3164.34 (SD = 2370.28). Using a scale of 0-10, our results indicate that a 1-point increase in total symptom severity burden is associated with a decrease of approximately 46 daily steps (B =  - 45.94, p < 0.001). Individual symptom analysis found that a one-point symptom increase corresponded with a 165-step count decrease with a one-point increase in fatigue (B =  - 165.33, p < 0.001), a 107-step decrease with increased nausea and vomiting (B =  - 107.49, p < 0.001), and a 28-step reduction in pain.

This study demonstrates a relationship between ePRO and step count in patients undergoing systemic cancer treatment across diagnoses. Notably, fatigue was the most prevalent symptom impacting activity, even more prevalent than nausea, vomiting, and pain. This secondary analysis reflects the potential for utilizing combined reporting measures such as ePRO and step count to increase symptom reporting and clinical response for patients undergoing systemic cancer treatment.