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Development of a Novel Remote Patient Monitoring System

The Advanced Symptom Management System for Radiotherapy to Improve the Symptom Experience of Patients With Lung Cancer Receiving Radiotherapy

Maguire, Roma PhD, MSc (Med Sci), BN, RGN; Ream, Emma PhD, MSc, BSc, RN, PG Dip Acad Practice; Richardson, Alison PhD, MSc, BN (Hons), Pg Dip Ed, RNT; Connaghan, John MSc, MA (Hons); Johnston, Bridget PhD, BN (Hons), PGCE (FE), RN; Kotronoulas, Grigorios PhD, MSc (Oncol Nurs & Palliat Care), BSN; Pedersen, Vibe MSc (Anth), MSc (HTA); McPhelim, John BSc Hon (Nursing), RGN; Pattison, Natalie DNSc, MSc, BSc (Hons), RN, Dip Onc; Smith, Allison MN (Cancer), RN; Webster, Lorraine BSc (Hons), DCRT (T), Dip Couns, Cert Couns; Taylor, Anne PhD, BSc (Hons), RGN; Kearney, Nora MSc, RGN

doi: 10.1097/NCC.0000000000000150

Background: The use of technology-enhanced patient-reported outcome measures to monitor the symptoms experienced by people with cancer is an effective way to offer timely care.

Objective: This study aimed to (a) explore the feasibility and acceptability of the Advanced Symptom Management System with patients with lung cancer receiving radiotherapy and clinicians involved in their care and (b) assess changes in patient outcomes during implementation of the Advanced Symptom Management System with patients with lung cancer receiving radiotherapy in clinical practice.

Methods: A repeated-measures, single-arm, mixed-methods study design was used involving poststudy interviews and completion of patient-reported outcome measures at baseline and end of treatment with 16 patients with lung cancer and 13 clinicians who used this mobile phone–based symptom monitoring system.

Results: Only rarely did patients report problems in using the handset and they felt that the system covered all relevant symptoms and helped them to manage their symptoms and effectively communicate with clinicians. Clinical improvements in patient anxiety, drowsiness, and self-care self-efficacy were also observed. Clinicians perceived the use of “real-time” risk algorithms and automated self-care advice provided to patients as positively contributing to clinical care. Reducing the complexity of the system was seen as important to promote its utility.

Conclusions: Although preliminary, these results suggest that monitoring patient symptoms using mobile technology in the context of radiotherapy for lung cancer is feasible and acceptable in clinical practice.

Implications for practice: Future research would be most beneficial if the use of this technology was focused on the postradiotherapy phase and expanded the scope of the system to encompass a wider range of supportive care needs.

Author Affiliations: School of Health and Social Care, University of Surrey, Guildford (Profs Maguire and Kearney and Dr Kotronoulas); Florence Nightingale School of Nursing, Kings College London (Prof Ream); Faculty of Health Sciences, University of Southampton and University Hospital Southampton NHS Foundation (Prof Richardson); School of Nursing and Midwifery, University of Dundee (Mr Connaghan); School of Health Sciences, University of Nottingham (Prof Johnston); Danish Patients Organisation, Copenhagen, Denmark (Ms Pedersen); NHS Lanarkshire (Mr McPhelim); The Royal Marsden NHS Foundation Trust, London (Dr Pattison); NHS Greater Glasgow and Clyde (Ms Smith); Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom (Ms Webster); Nursing and Midwifery Allied Health Professionals Research Unit, University of Stirling, United Kingdom (Dr Taylor).

All authors have equally contributed to the preparation of this manuscript.

This study was funded by the National Cancer Research Institute Supportive and Palliative Care Research Collaboratives (grant ID: LCSuPaC 16).

The authors have no conflicts of interest to disclose.

Correspondence: Roma Maguire, PhD, MSc (Med Sci), BN, RGN, School of Health and Social Care, Faculty of Health and Medical Sciences, University of Surrey, Duke of Kent Building, Guildford, Surrey, GU2 7TE, United Kingdom (

Accepted for publication February 17, 2014.

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