Cancer Symptom Monitoring Telephone System With Nurse Practitioner (NP) Follow up

The purpose of this prospective trial is to test a daily telephone based automated symptom
monitoring and response system to track and further treat unrelieved symptoms for patients
living at home during chemotherapy treatment as compared with usual care which consists of
patients calling their oncology provider for symptom concerns. For the intervention group,
the monitoring system is paired with automated delivery of self-care suggestions tailored to
the specific symptom profile the patient reported and also automatically 'alerts' the study
oncology nurse practitioner about unrelieved symptoms. The nurse practitioner, utilizing
national evidence based symptom guidelines for symptoms at moderate to severe levels calls
the patient and further assesses and intensifies symptom treatment. The usual care group
called the system daily and reported similar data but did not receive self-care coaching or
notification of unrelieved symptoms to the study nurse practitioner. On every call, the
usual care group was told to follow the standard procedure of calling their oncology
providers for symptom concerns. The specific aims of the study are to test whether the
symptom monitoring intervention reduces presence, severity and distress of 11 symptoms. The
symptoms monitored in the project were nausea/vomiting, pain, sore mouth, numbness &
tingling, diarrhea, trouble thinking, trouble sleeping, changes in appearance, depressed
mood, anxiety, and fatigue. Secondary outcomes tested whether the intervention improved
functional performance and decreased interference with activity when compared with the usual
care attentional control group. Other aims compare self care strategies utilized and their
perceived effectiveness and document patient satisfaction with the monitoring system.

Inclusion Criteria:

- Adult (age 18 or over)

- Have a histological diagnosis of cancer

- a life expectancy of at least 3 months and cognitively able to participate

- Beginning a new course of chemotherapy that is planned for a minimum of 3 cycles;

- care is under the direction of one of the 8 designated provider teams;

- English speaking;

- has access to a telephone on a daily basis and is able to use the phone unassisted as
verified by the study staff during participant orientation.

Exclusion Criteria:

- patients who are receiving concurrent radiation therapy (as they would have daily
contact with the health care system);

- patients who see the provider team for recommendation of a chemotherapy regimen but
treatment is then administered at a different site by other providers.

- Patients receiving therapy agents that result in a drug related fever or therapy
agents that are not anticipated to cause any of the 11 symptoms.