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Development and Feasibility Evaluation of a Nurse-Led ePRO System for Home-Based Post-Chemotherapy Symptom Management
Chiao-Chi Kuan1,2, Jhe-Cyuan Guo3,4,5, Shan-Hsiang Shen6
1Graduate Institute of Medical Sciences, College of Medicine, National Defense Medical University, Taipei City, Taiwan.
Background:
Electronic patient-reported outcome (ePRO) systems support symptom monitoring after chemotherapy; however, their integration into structured nurse-led oncology workflows remains limited. In this study, we aimed to develop and evaluate the short-term feasibility and usability of a nurse-led ePRO system for home-based postchemotherapy symptom monitoring and structured nursing triage for cancer patients.
Methods:
This single-arm feasibility study was conducted at a cancer center in Taiwan between April and September 2024 among adult patients requiring home-based symptom monitoring after hospital-based chemotherapy care. The nurse-led digital system was designed to support weekly self-reporting of 12 chemotherapy-related symptoms using the Chemotherapy Toxicity Self-Assessment Questionnaire. The system incorporated rule-based triage categorization using green, orange, and red risk levels and predefined nurse response protocols. Feasibility outcomes included report adherence, triage alert management, and system performance. Usability was evaluated using the System Usability Scale.
Results:
Forty-two patients submitted 306 symptom reports during the 8-week monitoring period, corresponding to an overall adherence rate of 91.1%. Among all reports, 16.3% generated orange alerts requiring nurse follow-up and 6.5% generated red alerts requiring urgent review. Fatigue, pain, and hand-foot syndrome were the most frequently reported abnormal symptoms. All orange and red alerts had documented nursing review. The system met the predefined technical performance indicators during simulated load testing, and achieved a mean System Usability Scale score of 92.6 ± 6.46.
Conclusions:
This nurse-led ePRO system demonstrated favorable short-term feasibility and usability for home-based postchemotherapy symptom monitoring and structured nursing triage. These findings support the practicality of integrating structured ePRO monitoring into postchemotherapy nursing care. Further multicenter and comparative studies are warranted to evaluate long-term engagement, scalability, and clinical outcomes.
