This project will evaluate the benefit of an automated home symptom monitoring system, Symptom Care at Home, to track COVID-19 symptoms, provide instructions to reduce COVID-19 exposure, and reduce cancer symptom severity during the COVID-19 pandemic. The investigators will determine if Symptom Care at Home decreases the need for cancer patients to use emergency departments and hospitalization for cancer symptom care. The project addresses the urgent public health need for cancer patients to reduce their risk for COVID-19 exposure.
In response to the COVID-19 pandemic, there is an opportunity to rapidly flex platforms for
remote cancer symptom tracking and management to incorporate COVID-19 symptom monitoring and
reinforce risk-reducing precautions. It is critical for cancer patients at home to monitor
early indications of COVID-19 symptoms, to adhere to mitigation strategies, as well as to
manage their cancer-related symptoms so that patients can decrease the need to utilize the
emergency department or unplanned hospitalizations for symptom care, which is a common
occurrence during cancer care. Remote monitoring adds a layer of home-based support which can
benefit all cancer patients and is not restricted to geographic proximity to oncology
providers or distance from a cancer center. The Symptom Care at Home (SCH) system, utilized
for the Principal Investigator's currently funded R01CA206522 project to monitor and manage
patient-reported (PRO) cancer symptoms, includes these necessary elements: remote PRO symptom
monitoring, patient self-management information, and oncology provider (nurse practitioner)
notification of symptoms exceeding pre-set thresholds. The overall purpose of this project is
to describe the impacts of COVID-19 on cancer patients' well-being at home and evaluate,
through a randomized clinical trial, if a systematic patient-reported outcomes (PRO)
reporting process improves cancer care during a pandemic as compared to usual care. Specific
Aims include: 1) describe patient-reported COVID-19 and cancer symptom trajectories over
time, COVID-19 social distancing and hygiene practices, and COVID-19 related cancer treatment
and daily living impacts on cancer patients receiving the SCH-COVID intervention and 2)
compare the SCH-COVID intervention to enhanced usual care on health care utilization,
COVID-19 diagnosis and outcomes, cancer treatment delays or changes, and patient-reported
global health, anxiety, mood, and feelings of social isolation.
Other: SCH Intervention
In addition to receiving usual care from their oncologist and staff, the SCH intervention group will report COVID-19 and cancer-related symptom presence and severity daily into the automated SCH system. Participants in the intervention receive automated self-management support messages for symptoms reported. In addition, COVID-19 symptoms and poorly controlled or worsening cancer symptoms will generate alerts. Based on preset thresholds, alerts automatically generate immediately from the patient's daily call data. The study nurse practitioners (NPs) monitor alerts. The NPs provide follow-up care using the guideline based SCH symptom clinical decision support system. The NPs log into the SCH Alert and Call Data website which displays all of the patients who have called that day and met an alert threshold. The NP calls the patient, delivers symptom management care by phone, and documents care in the patients' electronic health records.
Other Name: Symptom Care at Home Intervention
Inclusion Criteria:
- Participants will be patients who are receiving treatment for a cancer diagnosis at
Huntsman Cancer Hospital.
- Must be able to speak, read, and understand English language.
- Must have a smartphone and be willing and able to download the SCH application and
enter data into the application OR must be willing to make phone calls to report
symptoms using the telephone interactive voice response (IVR) system.
Exclusion Criteria:
- Patients enrolled in another study protocol that prohibits participation in other
trials.
- Patients under the age of 18.
Huntsman Cancer Institute
Salt Lake City, Utah, United States
Kathleen Mooney, PhD, Principal Investigator
University of Utah College of Nursing