Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 15, 2020
Open Peer Review Period: Apr 9, 2020 - Jun 4, 2020
Date Accepted: Aug 18, 2020
Date Submitted to PubMed: Oct 7, 2020
(closed for review but you can still tweet)
Safer systems through redundancy - patient held checklists for complications of systemic treatment for cancer shared by patients, friends and healthcare professionals: a prospective interventional cohort study
ABSTRACT
Background:
Advances in cancer management have been associated with an increase in emergency presentations with disease or treatment related complications.
Objective:
To measure ability of patients and members of their social network to complete checklists for complications of systemic treatment for cancer and examine impact on patient-centred and health-economic outcomes.
Methods:
Prospective interventional cohort study of a smartphone application with common complications of cancer used by patients undergoing systemic treatment for cancer, a nominated ‘safety buddy’ and acute oncology services. Comparator group of patients from the same institution. Measures were based on process (completion of checklists over 60 days), patient-centred outcomes included patient experience (Hospital Anxiety and Depression Scale (HADS) and the General version of the Functional Assessment of Cancer Therapy (FACT-G) at baseline, one month and two months) and health-economic outcomes (usage of appointments in primary care and elective and un-scheduled hospital admissions).
Results:
50 patients completed 2882 checklists and their 50 ‘safety buddies’ completed 318 checklists. Near daily usage was maintained over the 60-day study-period. Compared to a cohort of 50 patients with matching disease profile from the same institution patients in the intervention group had comparable changes in HADS and FACT-G. Patients in the Intervention Group required a third (32 vs 97 nights) of hospital days with overnight stay compared to patients in the Control Group (n.s.). The question ‘I feel safer with the checklist’ received a mean value of 4.27 (SD 0.87) on a Likert scale (1-5) for patients and mean 4.55 (SD 0.65) for family and friends.
Conclusions:
Patients undergoing treatment for cancer and their close contacts are able to complete checklists for common complications of systemic treatments and take an active role in systems supporting their own safety. To assess impact on clinical outcomes and health-economics a larger sample size is required. Clinical Trial: Research Ethics Committee reference: 18/WA/0213
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