Researchers Recommend Interventions as New Standard of Care for Patients with Oral Anticancer Agents

A study found that nurse-led follow-up and mobile health app leads to improved relative dose intensity, patient experiences, hospitalizations and their duration, and the rate of treatment-related grade 3 or higher toxicities.

Compared with the standard of care, investigators have found that implementing a nurse-led follow-up and mobile health app leads to improved relative dose intensity (RDI), patient experiences, hospitalizations and their duration, and the rate of treatment-related grade 3 or higher toxicities.

Results of the recent study were presented during the virtual science program of the 2020 American Society of Clinical Oncology (ASCO) Annual Meeting.

Multiple interventions aiming to improve the safe use of oral anticancer agents (OAA) have been reported in previous studies, including nurse-led follow-up and the use of health technology. The investigators noted, however, that these investigations have been limited by a lack of rigorous methodology.

In the new study, investigators randomized 609 patients initiating OAA to either receive a nurse navigator and a mobile application, or the standard of care. The nurse navigator provided regular follow-ups by phone in order to manage symptoms and assess toxicities, adherence, and other supportive care needs. The patients used a mobile phone application to record tracking data and contact the nurse via a secure messaging or dedicated phone line. The intervention lasted 6 months.

Between October 2016 and May 2019, 39% of the participants were receiving oral chemotherapy and 61% received another OAA. The RDI was significantly higher among those who received the intervention (93.4% vs. 89.4%).

Furthermore, the implementation of a nurse navigator and mobile app all improved Patient Assessment of Chronic Illness Care (PACIC) scores (mean: 2.94±0.83 vs. 2.67±0.89), the number of unplanned hospitalizations (15.1% vs. 22%), hospitalization duration (mean: 2.82±6.96 days vs. 4.44±9.60), and treatment related toxicities at grade 3 or higher (27.6% vs. 36.9%).

The investigators concluded that this intervention results in a notable improvement for patients and should be considered a new standard in patients receiving OAA.

REFERENCE

Mir O, Ferrua M, Fourcade A, et al. Intervention combining nurse navigators (NNs) and a mobile application versus standard of care (SOC) in cancer patients (pts) treated with oral anticancer agents (OAA): Results of CapRI, a single-center, randomized phase III trial [ASCO abstract 2000]. J Clin Oncol. 2020;38(suppl). doi:10.1200/JCO.2020.38.15_suppl.2000.