1836P - Patient-reported health behaviors (PRHB) among 1850 patients enrolled in a remote patient monitoring (RPM) pathway

Background

Health behaviors including smoking, alcohol consumption and physical activity affect pts’ health outcomes and quality of life. However, screening for these modifiable factors is provider-dependent and not systematically done across centers, potentially driving care disparities. RPM based on electronic patient-reported outcomes (ePRO) offers a way to track health behaviors, enhancing patient-provider communication on health promotion, and allowing early interventions. We tested the feasibility of assessing PRHB using an RPM pathway and their association with symptom burden, RPM adherence and engagement with digital educational resources.

Methods

Pts enrolled in the Resilience RPM pathway from 8/23-4/24 responded to single-item questions from validated ePRO covering smoking (frequency and quit attempt), alcohol consumption (frequency and quantity) and physical activity. PRHB profile was defined as unhealthy (active consumption/not active) vs healthy (no consumption/active). Symptom burden was defined by alert rates (severe or worsening symptoms), whereas RPM adherence by weekly ePRO reporting rates and engagement with digital education by amount of resources consulted in the Resilience mobile app interface. Multivariable regression assessed associations of PRHB with outcomes adjusting by age, sex, stage and social determinants.

Results

Among 3189 pts, 1850 (58%) provided PRHB data (median age 62 years [P25-75 52-71]); 67% female). Most common primary tumor was breast (44%) and gastrointestinal (23%), 55% were non-metastatic. 69% reported at least 1 unhealthy PRHB: 13% were current smokers (46% reported a quit attempt), 32% reported alcohol consumption, 49% were physically inactive. Physical inactivity was associated with higher symptom burden (β 9.87, p < 0.001), lower RPM adherence (β -2.34, p < 0.028), and lower engagement with digital educational resources (β 1.74, p < 0.001). Smoking and alcohol consumption were not associated with outcomes.

Conclusions

Screening health behaviors directly from pts was feasible in a large real-world cohort using RPM, detecting high rates of unhealthy behaviors. This approach can enable personalization of care, and aid in supportive care referrals.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Gustave Roussy and Resilience.

Funding

BCRF/ Conquer Cancer Foundation; Resilience.

Disclosure

M.A. Franzoi: Financial Interests, Institutional, Invited Speaker: Novartis; Financial Interests, Institutional, Research Grant: Resilience. A. Di Meglio: Financial Interests, Personal, Advisory Board: Kephren, Medycis, Techspert. M. di Palma: Financial Interests, Personal, Invited Speaker: Amgen, KyowaKirin, MSD, BMS, Mundipharma, Astellas, Ipsen, Lilly, Merck, Gilead, Roche, Novartis; Financial Interests, Personal, Advisory Board: AstraZeneca, Sandoz, Esteve, AatraZeneca, Janssen, Pfizer, Roche, VIIV Lelthcare, FreseniusKabi, Mundipharma; Financial Interests, Institutional, Other, preceptorship: Sandoz; Financial Interests, Personal, Other, masterclass: Daiichi, Beigene; Financial Interests, Personal, Other, travel expenses: Viatris; Financial Interests, Institutional, Invited Speaker: Resilience; Financial Interests, Personal, Other, Travel expenses: Viatris; Financial Interests, Personal, Steering Committee Member: Fresenius, Bayer; Financial Interests, Institutional, Other, investigator: Sandoz, Pierre Fabre, Novartis, Ipsen, Janssen, AstraZeneca; Non-Financial Interests, Member of Board of Directors: French Speaking Association for Supportive Care in Cancer; Non-Financial Interests, Other, member: Ethical Comittee of the French National League against cancer. T. Grellety: Financial Interests, Personal, Advisory Board: Astrazeneca, Pfizer, Novartis, Lilly, Roche. L. Polastro: Financial Interests, Personal, Speaker’s Bureau: Resilience; Financial Interests, Institutional, Research Funding: Resilience. C. Ferté, A. Diab: Financial Interests, Personal, Full or part-time Employment: Resilience. A.R. Ferreira: Financial Interests, Personal, Advisory Board: Roche, Novartis, Merck Sharp & Dohme, Seagen; Financial Interests, Personal, Invited Speaker: Roche, Novartis, Gilead Sciences; Financial Interests, Personal, Full or part-time Employment: Resilience. E. Basch: Financial Interests, Personal, Stocks or ownership: Vector Science; Financial Interests, Personal, Advisory Role: Sivan Innovation, AstraZeneca, Resilience. F. Scotté: Financial Interests, Personal, Advisory Board, Meetings: Leo Pharma; Financial Interests, Personal, Invited Speaker, symposia: Amgen, MSD, Thermofisher, BMS, Pfizer, MundiPharma, Tilray; Financial Interests, Personal, Invited Speaker: Pierre Fabre Oncology, Clovis Oncology, Gilead, Grünenthal, Pharmanovia; Financial Interests, Personal, Advisory Board: Viatris-Mylan, Viforpharma, Helsinn, Chugai, Sanofi, Sandoz, GSK; Non-Financial Interests, Other, member of faculty for supportive and palliative care: ESMO; Non-Financial Interests, Member of Board of Directors: MASCC, AFSOS. I.V. Vaz Luis: Financial Interests, Institutional, Invited Speaker: Amgen, Pfizer/Edimark, AstraZeneca; Financial Interests, Institutional, Writing Engagement: Pfizer/Edimark; Financial Interests, Institutional, Advisory Board, Consulting/ AB: Novartis; Financial Interests, Institutional, Advisory Board: Sandoz; Financial Interests, Personal, Other, Travelling: Novartis; Financial Interests, Institutional, Other, Research Funding: Resilience; Financial Interests, Institutional, Funding: Resilience; Non-Financial Interests, Member, Member of WG: ASCO. All other authors have declared no conflicts of interest.