Research on symptom management and monitoring of health-related quality of life (HRQOL) among cancer patients has typically focused on the active treatment phase. 1-7 More recently, greater attention has been given to the psychosocial needs and follow-up care plans for survivors. 8 Several technology-assisted symptom/HRQOL monitoring systems with routine assessments have been shown to be easy to use, 1,3,5,9-16 readily accepted by patients, 3,9,11,14,15,17,18 helpful in communication between patients and providers, 3,9,11,13,15 and a means of overcoming numerous barriers to conducting routine assessments. 16,19-23 Real-time clinician feedback at the point-of-care appears to be a crucial component of these systems, giving patients and providers a systematic way of discussing symptoms and aspects of HRQOL that are often addressed only informally or not at all.
To date, 6 randomized controlled trials (RCTs) have assessed the impact of technology-assisted interventions among cancer patients. 6,23-27 There was significant variability across these studies, including differing sample sizes, number of intervention contacts, tumor site (eg, breast, lung, colon), outcomes assessed (eg, symptom distress, communication, and HRQOL), and types of technology used (eg, touch-screen computers, telephone systems). The methodological differences make it difficult to compare these studies, although a common thread was that patients found the systems easy to use and they generally perceived the systems as beneficial. 6,23-27
Despite the positive response from participants, only 2 of the 6 RCTs demonstrated positive outcomes for the intervention over the control group. 23,25 In a study of 286 cancer patients and 28 oncologists, Velikova et al (2004) found that both the intervention and the attentioncontrol groups had better HRQOL than the control group over a 6-month period. 23 Among the intervention patients, the HRQOL improvement was related to clear use of the HRQOL data by physicians, and to physician/ patient discussion of pain and role function. A positive effect on emotional well-being was associated with feedback of the data to physicians. However, there were no significant differences between the intervention and attention-control groups.