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Evaluation of a remote symptom assessment and monitoring system (SAM) for people receiving adjuvant chemotherapy for breast or colorectal cancer
ABSTRACT
Background:
Background:
The Symptom Assessment Management programme (SAM) is an online structured nurse-supported intervention to support symptom self-management in people receiving adjuvant chemotherapy post surgery for breast or colorectal cancer.
Objective:
Objective:
To describe the development, implementation strategy and evaluation of the intervention.
Methods:
Methods:
The development of the programme involved three phases. In phase 1, the web-based system was developed through consultation with consumers, clinicians and the literature to ensure the system was both evidence-based and reflected the realities of receiving treatment and supporting patients through treatment. In phase 2, seven participants recorded the severity of six symptoms daily over the course of one cycle of chemotherapy. Seventeen participants took part in phase 3, recording their symptoms daily over the course of three cycles of chemotherapy. Once symptoms were recorded, participants received immediate feedback on the severity of their symptoms and self-management recommendations, which could include seeking immediate medical attention. Data on quality of life, symptom burden, anxiety and depression, distress and self-efficacy were collected during treatment and participants’ perceptions of SAM were evaluated post participation by interview.
Results:
Results:
The outcomes of the project include the development of a system that is reliable, and easy to use and navigate. Participants reported benefits related to using SAM including feeling more in control of managing symptoms and feeling reassured. Engagement with the system on a daily basis was variable and included those who completed the symptom tracker on a daily basis, to those who engaged some of the time. The feedback from all participants was that the system was easy to navigate and the information relevant and supportive.
Conclusions:
Conclusions:
SAM has the potential to enhance the management of symptoms for people receiving chemotherapy treatment. SAM created an accurate repository of symptoms that can be accessed easily and highlight patterns in symptom experience. These can be shared with clinicians, with patient permission, to inform and support treatment plans. The potential to predict the risk of developing severe symptoms can be developed to anticipate the need for care and support. Further consideration on how to increase engagement with the system, the value of the system for people diagnosed with other tumour types and treatment regimes, and the incorporation of the system into everyday clinical practice, are key future considerations.
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