Patients treated in a chemotherapy day unit can benefit from “STAR”, an innovative monitoring program to improve cancer management and reduce waiting-time as well as drug wastage. Two days before anticancer treatment, according to patient preference, a nurse (call) or the patient himself (web) completes a clinical data questionnaire. The aim of the study was to compare the reliability of those two methods of data collection.
Clinical information prospectively collected on STAR questionnaires during 11 months were compared using Mantel-Haenszel khi2 (p-values) in the 2 groups (nurse call versus web self-questionnaire). Numbers of symptoms were classified into 3 categories: 0, 1 and at least 2 symptoms for each grade of severity (NCI-CTC AE, version 4.0).
From May 2017 to April 2018, 622 (67.1%) of 928 patients admitted to daily hospital for a chemotherapy cycle were included in the STAR program. Monitoring was ensured by nurse phone calls for 477 patients (76.7%) versus 145 (23.3%) by web questionnaires. Patient’s average age (66±11 years) and sex repartition (61% of men) were not different in the 2 groups. The overall rate of response was significantly better with nurse calls (84.8%) than with web questionnaires (78.2%) (p < 0.0001). Global incidence of grade 3 and grade 4 toxicities was similar in the two groups (p = 0.1 and 0.06 respectively) whereas web questionnaires mentioned significantly more grade 2 and grade 1 toxicities (p < 0.0001). When chemotherapy cycle was cancelled for a clinical reason, this information was similarly mentioned in the 2 groups (p = 0.35). Overall, global rate of delayed chemotherapy did not differ between the two groups.
Web questionnaires appear to be an interesting and reliable method for patient clinical monitoring. To take full advantage of STAR program, the importance of clinical evaluation should be reminded to patients to increase the rate of response. Web monitoring improvement in grade 1-2 toxicities screening should be explained by a better patient understanding and will be investigated in further studies.
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