Remote real-time monitoring for chemotherapy side-effects in patients with blood cancers

Background: Chemotherapy for patients with blood cancers commonly results in distressing/potentially life-threatening toxicities/side-effects. Patients receiving outpatient chemotherapy are therefore responsible for monitoring/management of complex side-effects between clinical visits. The quality and safety of care in this patient group may be improved by a remote real-time Telehealth system which reports patient data directly to the clinical treatment team. Aim: This study evaluated the acceptability, useability and feasibility of a real-time, remote Telehealth monitoring/management system. Methods: Patients with blood cancers receiving chemotherapy, who consented to study participation, were trained to use the Telehealth application on a smart-phone. Patients entered side-effect data for one cycle of chemotherapy. Data exceeding pre-set thresholds triggered alerts (via Short-Message-Service) to clinic nurses for actioning. At study conclusion patients completed semi-structured interviews about the experience of using the Telehealth system which were: recorded, transcribed and; underwent content analysis. Findings: Seventeen patients used the system and completed the interview. The system was easy-to use and fitted with daily routines. Perceived benefits included: reassurance; empowerment; increased health-awareness/adherence to self-care; promotion of timely clinical intervention and improved recall of side-effects and communication with clinicians/family/friends. The system was more beneficial to those experiencing more numerous side-effects. Suggested changes included: language clarification and additional side-effect monitoring. Discussion: Use of a revised system was supported as an adjunct to current practice. Future use of a similar Telehealth system would enhance current pre-chemotherapy education, patient self-care adherence, alongside improved side-effect communication. Conclusion: Additional randomised controlled trials are required to elucidate quantitative improvements in health outcomes prior to clinical introduction. (C) 2016 Australian College of Nursing Ltd. Published by Elsevier Ltd.