Patients undergoing chemotherapy often experience difficult but treatable symptoms – including fatigue, pain, and nausea — in between health care appointments. But because providers are often not aware of them, some patients undergo unnecessary suffering. A new study by investigators at Huntsman Cancer Institute and the College of Nursing at the University of Utah suggest that relief could be just a phone call away.
To address the care gap, the researchers enrolled 385 cancer patients undergoing chemotherapy who called an automated telephone system daily to rate the presence and severity of 11 symptoms on a scale of zero to 10 using the keypad on their phone. The calls took less than five minutes each day. Half of the patients also took part in the investigational Symptom Care at Home program. This group also received automated tips to help them self-manage their symptoms. The system then sent alerts to nurse practitioners for patient reports of moderate to severe symptoms. The nurse practitioners called these patients and provided further symptom treatment according to guidelines provided by the National Comprehensive Cancer Network. Patients who were not enrolled in the Symptom Care at Home program were reminded to contact their oncology team for symptom concerns. However, they did this only a small fraction of the time.
Patients enrolled in the Symptom Care at Home program fared much better than those who weren't in the program. They experienced fewer days with severe (67 percent less) and moderate (39 percent less) symptoms. Combining severity ratings for all symptoms revealed that the Symptom Care at Home group had a 43 percent reduction in severity compared to those not using the program. The study suggests that patients undergoing chemotherapy suffer much more at home than they report to their oncology team, and that automated telephone monitoring and coaching about symptom care may significantly improve the well-being and quality of life of patients during cancer treatment.