Electronic patient-reported monitoring of symptoms during follow-up of ovarian cancer patients: a feasibility study

Fiona Kennedy, Leanne Shearsmith, Marie Holmes, Zoe Rogers, Rob Carter, Uschi Hofmann, Galina Velikova, Fiona Kennedy, Leanne Shearsmith, Marie Holmes, Zoe Rogers, Rob Carter, Uschi Hofmann, Galina Velikova

Abstract

Background: Ovarian cancer patients require monitoring for relapse. Innovative follow-up methods are increasingly being explored. An electronic patient-reported outcome (ePRO) follow-up pathway was developed for women treated for ovarian cancer. This feasibility study explored patient acceptability and compliance.

Methods: A single-arm non-blinded prospective feasibility study was undertaken at two hospitals. Participants were women who had completed treatment for ovarian cancer whose clinician was happy for them to be monitored remotely. Automated 3-monthly reminders were sent to participants to complete an ePRO questionnaire and obtain blood tests. Participants were reviewed over the phone by their clinical nurse specialist instead of attending clinic-based follow-up. The primary outcome was compliance (expected ePRO completions/blood tests) across the 12-month study period. Secondary outcomes were recruitment, attrition, resource use, symptom severity/alerts and patient acceptability.

Results: Twenty-four women consented (50% consent rate), and 13 remained on study at 12 months. Seven women relapsed, 3 chose to withdraw, and 1 withdrew for other clinical reasons. ePRO compliance was high and consistent at 75-82%, although the two hospitals differed. Adherence to the clinical protocol was evident for blood tests and contacts with staff (fewer visits, more phonecalls compared to an earlier audit). End-of-study feedback indicated high patient satisfaction.

Conclusions: Remote ePRO follow-up for ovarian cancer is feasible and acceptable to patients who are able and willing to participate. However, the low recruitment rate (ineligible + declined) indicate it is not suitable/acceptable to all patients immediately post-treatment. Further large-scale research and implementation work is required, especially in a post-COVID era.

Trial registration: ClinicalTrials.gov ID: NCT02847715 (first registered 19/05/2016).

Keywords: Acceptability; Compliance; Electronic patient-reported outcomes; Feasibility study; Follow-up; Ovarian cancer.

Conflict of interest statement

FK reports a research grant from Breast Cancer Now. GV reports honoraria from: Roche, Eisai, Novartis and Seattle Genetics, and research grants from Breast Cancer Now, EORTC, Yorkshire Cancer Research, Pfizer and IQVIA. All other authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Schedule of study activities and assessments
Fig. 2
Fig. 2
Consort diagram
Fig. 3
Fig. 3
Actual, expected and percentage compliance at each time point overall (a), and for each hospital site (b, c)
Fig. 4
Fig. 4
Swimmer plot illustrating all scheduled (3, 6, 9, 12 month, purple symbols) and any unscheduled completions (red cross) across study period for each participant presented by the three study status categories: (a) completed 12 month study, (b) relapsed, (c) withdrawn. a 12 month participants. b Relapse participants.c Withdrawal participants

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