About our work
This study builds on previous work carried out by the Cancer Care Research Centre in the use of ASyMS©, which has shown its potential in improving the management of treatment-related symptoms in people with breast, lung or colorectal cancer receiving chemotherapy treatment, in young people with cancer receiving chemotherapy and in people with cancer with palliative care needs. This mobile phone-based, remote monitoring Advanced Symptom Management System technology will therefore be tested in patients with lung cancer who are receiving radiotherapy (ASyMS©-R), to assess its practicability and effectiveness in monitoring and managing radiotherapy-related symptoms in this patient group.
How has this study developed?
Patients with lung cancer who are undergoing radiotherapy treatment are known to experience a number of symptoms related to both their treatment and disease. However, within the UK, evidence suggests that there is no standardised way to assess symptoms in such patients and thus it is probable that symptom management in this patient group is not optimal. It is also indicated that symptoms in cancer patients are regularly poorly assessed and managed and patients continue to report a high burden of common symptoms. These findings suggest that a means of improving symptom management would benefit people with lung cancer receiving radiotherapy.
How was the study carried out?
There were 2 phases in this study. At the alpha testing stage we tested the system to make sure it was reliable, usable and acceptable in a small number of patients receiving palliative care. Once it was known the system worked properly, the Beta stage used the system to monitor and manage symptoms in patients receiving palliative care at home and explored how patient & health care professionals' felt about the system.
What is the main aim of the study?
The main aim of this study is to develop a mobile phone-based, remote monitoring Advanced Symptom Management System (ASyMS©-R) for the management of symptoms in patients with lung cancer receiving radiotherapy and to assess the feasibility and acceptability of the system within clinical practice.
How is the study carried out?
The study will be conducted in two phases. Phase 1 will comprise review and system development and will:
- review existing methods of symptoms assessment and provision of self-care advice in patients with lung cancer receiving radiotherapy in the UK by asking lead radiotherapy clinicians to take part in a survey by electronic e-mail on their current methods of symptom assessment (including tools used, frequency of assessment and profile of patients' symptoms);
- review the literature (1998-2008) on the key symptoms experienced by people with lung cancer receiving radiotherapy, to explicate the symptoms to be assessed, the provision of self-care advice and the development of a risk modelling tool to generate alerts
- carry out two focus groups with patients to gather views on their symptoms and care;
- carry out two focus groups with radiotherapy cancer care clinicians to collect their views on symptoms to be assessed, preferences related to self-care advice for patients, criteria for generating alerts and their requirements for the monitoring system.
Phase 2 will explore the early feasibility and acceptability of ASyMS©-R in 45 patients with lung cancer receiving radiotherapy, who will use the mobile phone system during and one month post-radiotherapy treatment to enter symptom data and receive self-care information from their clinicians and complete a diary. In doing this, the project will aim to:
- test the electronic method of data capture, symptom assessment, transfer of symptom information and generation of alerts to the clinical site;
- test the validity and reliability of the symptom assessment tool used in ASyMS©-R;
- explore the feasibility and acceptability of ASyMS©-R in patients with lung cancer receiving radiotherapy and clinicians involved in radiotherapy treatment;
- establish the appropriate alerting system to assist early intervention;
- explore the perceptions of patients and health professionals in relation to the content and delivery of self-care advice
- explore the potential for ASyMS©-R integration into the Common Assessment Framework and electronic patient-held record system;
- assess the suitability of outcome measures for use in a future randomised controlled trial.
Why is this research important?
It is important to conduct research with people with lung cancer who are receiving radiotherapy because many people receiving this form of treatment can experience unpleasant and distressing side effects which can affect their quality of life. As most radiotherapy is given on an outpatient basis, patients are often required to manage the side effects they encounter at home, without a great deal of direct supervision from health professionals. In the UK at the moment there is no standard way to assess the symptoms patients experience during the course of receiving radiotherapy for lung cancer. This study is therefore needed in order to develop a system to meet the specific needs of this group of patients and the results we obtain may help to improve the provision of cancer services in the future for other people with lung cancer who receive radiotherapy treatment.
Who will take part?
In Phase 1, the lead radiotherapy clinicians from all the 62 Radiotherapy centres in the UK will be invited to participate in the electronic survey. Also in Phase 1, a set of patients over 18 years old with lung cancer who are/have received radiotherapy, and cancer clinicians specialising in radiotherapy, will be approached to take part in focus groups. In Phase 2, 45 patients will be recruited to the study from four clinical sites to record data on ASyMS©-R daily during treatment and for 1 month follow-up; 15 of these will be asked to record data during the follow-up period weekly for three months, to assess the long-term feasibility of the system.
Who are we working with?
The study will be run in collaboration with Professor Yvonne Wengström and Roma Maguire from the CCRC, Professor Alison Richardson, Chair in Cancer and Palliative Nursing Care at Kings' College, London and Dr Mohammed Rizwanullah, Consultant Clinical Oncologist from the Beatson West of Scotland Cancer Centre and also with Kelvin Connect (a Glasgow-based company who develop innovative mobile data management solutions on hand-held computers).
Two of the four clinical sites involved in the project will be located in the west of Scotland and two in London.
When is the research project due to be completed?
The study will run from January 2009 and is due to be completed in April 2010.
Funding Organisation
The study is funded by the National Cancer Research Institute Supportive and Palliative Care Research Collaborative.
More Information
For more information on ASyMS© please contact Professor Nora Kearney.