Keywords

Daily symptom monitoring, Feasibility, Function, Gynecologic oncology, Patient-reported outcome measures

 

Authors

  1. Campbell, Grace B. PhD, MSW, RN, CRRN, FARN
  2. Belcher, Sarah M. PhD, RN, OCN
  3. Lee, Young Ji PhD, MSN, RN
  4. Courtney-Brooks, Madeleine MD, MPH, FACOG
  5. Bovbjerg, Dana H. PhD
  6. Bizhanova, Zhadyra MBChB, MPH
  7. Donovan, Heidi S. PhD, RN

Abstract

Background: Women receiving chemotherapy for gynecologic cancer (GC) experience severe symptoms with associated functional changes. Understanding day-to-day symptom and function variation within and across chemotherapy treatment cycles could inform improved symptom management, but such studies are rare and may be infeasible in clinical care.

 

Objective: The aim of this study was to evaluate feasibility and acceptability of daily symptom monitoring combined with objective and self-reported functional assessments every 21 days during active chemotherapy for GC.

 

Methods: Thirty women enrolled in a prospective observational study during first-line chemotherapy completed a daily symptom and falls diary during their entire chemotherapy treatment period. Patient-reported outcomes and objective symptom and function testing were assessed before each chemotherapy appointment. Study outcomes included accrual and attrition rates, completion of study assessments, and qualitative perceptions of study participation.

 

Results: Participants were 92% White, 60% had high school or higher education, 68% were married/partnered, and 62% had stage III or IV cancer at diagnosis. The study had an 83% accrual rate, 6.6% early withdrawal rate, and 17% total attrition rate. Missing assessments for prechemotherapy patient-reported outcomes and objective assessments ranged from 27% to 35% and 35% to 47% respectively, with a general decrease across cycles. Daily diary completion rate was 83% overall. Participants rated study participation positively.

 

Conclusions: Intensive daily symptom and function monitoring was feasible and acceptable to GC patients and may provide a sense of symptom controllability.

 

Implications for Practice: Daily symptom and function monitoring in research studies may provide patients with information to support symptom discussions with the clinical team. Future work should develop proactive symptom management interventions using personalized symptom trajectories.