Today, many of us either know of someone living with a long-term condition or are dealing with one ourselves.
Medical advancement and healthier lifestyles enable us to live longer with conditions ranging from arthritis and type-2 diabetes to cancer, which is no longer the death sentence it once was.
While this is an achievement, it’s also placing more strain on healthcare services. According to a study published by the NHS in 2014, people living with a long-term condition account for 50% of G.P. appointments, 70% of all hospital beds, and 70% of total health and social care costs.
At Cemplicity, we’ve been asking how we can support healthcare systems to do more with less; how to offer more active support to all patients and improve their quality of life, while streamlining specialist resources, so that they will have the most impact. This is a particularly pertinent question given the enormous backlogs for surgery and treatments created by COVID-19.
So, how can a software company known for electronic patient-reported outcomes (ePRO), make a difference? Seems impossible, right?
Let’s look at the Basch study (2017). This respected study, run over 8 years with almost 800 cancer patients, measured the impact of tracking patients between treatments using an ePRO.
The control group received the usual cancer treatment, while the test group was prompted to provide regular symptom feedback electronically. If the patients’ feedback suggested anything alarming or abnormal, the system sent an automated email alert to a clinical nurse responsible for the patient.
The results were telling. Over the 8 years, the survival rate of patients receiving ePRO was as high as 10% more than that of patients receiving routine care, a stronger outcome than most new cancer drugs.
Several factors contributed to this increase in survival rate, but in particular, patient symptoms were better managed. Mr. Ethan Basch, Professor of Medicine at the Lineberger Comprehensive Cancer Center of the University of North Carolina and author of the study, commented that “patients receiving chemotherapy often have severe symptoms, but doctors and nurses are unaware of these symptoms up to half of the time.” In almost every case, when an email alert was triggered, the nurse took action, including advising the patient on symptom management, changing medication, or referring the patient to the hospital. Patients receiving the ePRO and follow up from the nurses continued their chemotherapy treatments 33% longer than the control group, a major contributor to the improved outcomes.
Additionally, patients who self-reported symptoms were less frequently admitted to the E.R. or hospitalised, and in these COVID-19 times, ePROs can reduce unnecessary hospital visits keeping both patients and staff safer.
What Cemplicity has learned from its own ePRO work is that patients feel substantially more supported when they are actively participating in their care. Healthcare systems that incorporate ePRO programmes into their services will offer patients more inclusivity in their treatment, and improve their overall experience of care.
Research conducted by the Breast Cancer Foundation NZ (BCFNZ) found that patients with advanced breast cancer experience, on average, 14 symptoms. Treatment for advanced breast cancer can be toxic, and life expectancy for New Zealand (NZ) women is less than in many other countries.
Care teams’ ability to stay in closer contact with women at home, track changes in their symptoms, and step in quickly if needed, is seen as a significant opportunity to support NZ women. This real-time contact also encourages them to adhere to medication regimens, which are often taxing but life-saving. The BCFNZ aim is to extend survival with good quality of life without high cost on healthcare resources. Importantly, this allows specialists to focus on the patients in most need of their care.
Cemplicity staff spend a lot of time reviewing evidence and gathering ideas from our clinical colleagues and patients. But sometimes it’s useful to pause and to personalise what we are writing about. If you have been to a hospital or a clinic for treatment, and are sent home to recover and self-medicate, how much more confident and supported would you feel if you received regular, easy-to-respond to, contact from your care team?