Using Technology to Assess and Manage Symptoms in Cancer Care

Transcription

1 Using Technology to Assess and Manage Symptoms in Cancer Care Roma Maguire Professor of ehealth School of Health Sciences University of Surrey Tuesday, 29 November

2 Cancer tidal wave on the horizon It is estimated that worldwide there will be 23.6 million new cases of cancer each year by

3 Mortality associated with chemotherapy treatment 30-day mortality after systemic anticancer treatment for breast and lung cancer in England: a population-based, observational study Wallington, Michael et al. The Lancet Oncology, Volume 17, Issue 9, Summary of 30-day mortality rates in patients with breast or lung cancer by treatment intent. Data are n (%) of total patients by cancer type and treatment intent; and n (%) of deaths occurring within 30 days of systemic anticancer therapy for each of those groups. Tuesday, 29 November

4 Symptoms associated with chemotherapy Symptom Prevalence in Lung and Colorectal Cancer Patients Walling, Anne M. et al. Journal of Pain and Symptom Management, Volume 49, Issue 2, Tuesday, 29 November

5 Cancer related symptoms: Negative impact on patient outcomes Morbidity Mortality Quality of Life Symptom Burden Medicines Compliance Anxiety Depression Physical Functioning Supportive Care Needs Work Limitations Wednesday 29th April

6 home primary care center community care center local hospital regional/specialist hospital Evolution of healthcare up until the late twentieth century Evolution of healthcare since the late twentieth century Evolution of laboratory medicine up until the late twentieth century Point-of-care testing for the future Price et al 2010

7 Wednesday 29th April

8 Is ICT the solution? Tuesday, 29 November

9 What are patient reported outcome measures?..comprise of information from patients about a health condition and its management (Lohr & Zebrack, 2009) The distinction between a PRO and an observer generated report is that the PRO is a self-report made directly by the patient without being made through another party (Osoba, 2007)

10 PROMs Reported benefits of the use of PROM s in clinical practice: Identification of patient concerns (patients feel more cared for) identification of bio-psychosocial issues traditionally overlooked more timely reporting and management of symptoms less patient anxiety greater patient satisfaction with care promotion of self care improved communication between patients and health professionals (Donaldson, 2008; McPhail et al, 2010; Marshall et al, 2006; Snyder and Aaronson, 2009))

11 e-patient Reported Outcomes Systematic assessment Real time not retrospective Rapid therapeutic response Facilitate patient centered care Access geographical locations Basch et al 2008; Kearney et al 2009; Snyder et al 2011

12 Supported Self Care 11/29/

13 Information provision 11/29/

14 The Advanced Symptom Management System Programme of research spanning over the past 10 years One of the most evolved and tested mhealth system in Cancer Care Developed in conjunction with people with cancer and cancer care experts (inductive and iterative development) Person centred Rigorous framework for intervention development (MRC Complex Interventions Framework, 2008)

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16 ASyMS: Patient Support ASyMS ASyMS ASyMS ASyMS ASyMS ASyMS

17 Electronic Symptom Management System Remote Technology Randomised controlled trial to evaluate electronic Symptom Management using the Advanced Symptom Management System (ASyMS) Remote Technology for patients with cancers Wednesday 29th April

18 EU FP7 funded 6M ASyMS remote patient monitoring intervention in Europe 10 European and 1 US partner University of Surrey: Consortium lead

19 University of Surrey University of Dundee University of California, San Francisco Medical University of Vienna, Austria NHS 24 Kings College London, UK University of Athens, Greece University of Dublin, Ireland Innlandet Hospital Trust, Norway The European Cancer Patient Coalition (ECPC) Docobo Partner Vienna Dublin Dublin Dublin Athens Athens Athens Oslo Portsmouth London London London London 14 Clinical sites Medical University Vienna St James s Hospital St Vincent s University Hospital St Vincent s Private Hospital Medical Unit Agioi Anargiri Cancer Hospital Medical Unit St Savvas Cancer Hospital Medical Oncology Unit Air Force General Hospital Innlandet Hospital Trust (X2) Queen Alexandra Hospital UCLH Mount Vernon Cancer Centre Guy s and St Thomas St George s London

20 RCT >1000 Patients with breast cancer, colorectal cancer or lymphoma Patients receiving chemotherapy and 1 year post treatment (symptom burden, supportive care needs, self efficacy, work limitations, quality of life) Predictive Risk model development

21 Patient questionnaire

22 Automated evidence based self care advice Advice is automatically created in response to the answers selected by the patient

23 ASyMS WEBSITE: Handling Alerts Clinical Assessment Centre

24 Use of PRMs in practice preventative and anticipatory chemotherapy toxicity management source: Thursday, 4 August

25 The future.personalised care Tuesday, 29 November

26 Delivering the vision of Connected Health. Wednesday 29th April

27 Thank This project has received funding from the European Union s Seventh Framework Programme for research, technological development and demonstration under grant agreement number Tuesday, 29 November