Table 2

Summary of studies

Author, publication year, country, number of participants (n).Clinical settingMonitoringPROM feedback mechanism (intervention group)
Anderson 2015,17 USA, n=60Outpatient oncology. Breast cancerAutomated telephone monitoring twice weekly for 8 weeksOncologist emailed if symptom reached thresholds. Symptom summaries given to oncologists before scheduled appointments
Aubin 2006,19 Canada, n=80Community palliative care. Mixed cancer typesTwice daily paper diary for 4 weeksPatient instructed to contact their nurse if pain or analgesic use reached a set threshold. Nurse liaised with prescribing physician
Berry 2011,20 USA, n=660 (ESRA-C 1 intervention)Outpatient oncology. Mixed cancer typesPreclinic on touch screen notebook computers on 2 occasionsColour graphical summaries handed to the clinician before appointments or attached to clinical notes
Berry 2014,21 USA, n=752 (ESRA-C 2 intervention)Outpatient oncology. mixed cancer typesInternet-based form (completed at home or on clinic PCs) at 3 points over 8 weeksSymptoms above a threshold automatically produced tailored coaching messages on how to describe the problem to the clinical team. PROM graphs and coaching messages could be viewed by the patient at any time 
Bertsche 2009,23 Germany, n=100Inpatient oncology. Mixed cancer typesDaily inpatient assessmentPain scores linked to algorithmic pain management instructions
Cleeland 2011,18 USA, n=100Postoperative outpatient. Primary lung cancer or lung metastasesTwice weekly automated telephone calls for 4 weeksAn email alert was sent to the advanced nurse practitioner if any symptoms were above a threshold.
De Wit 2001,24 the Netherlands, n=313, and Van Der Peet,44 2009, the Netherlands, n=120Community palliative care. Mixed cancer typesTwice daily paper pain diary for 2 monthsPatient's knowledge, attitude and pain ratings used to tailor education and advice about non-pharmacological strategies
Du Pen 1999,26 USA, n=81Outpatient oncology. Mixed cancer typesDaily paper diary for 3 monthsPain ratings, side effects and analgesic use mapped to algorithmic pain management guidelines for physicians
Given 2004,27 USA, n=237Outpatient oncology. Mixed cancer typesFortnightly report to nurse (face-to-face and by telephone) over 20 weeksSymptoms above a threshold lead the nurse to provide specific self-management instructions and coaching
Hoekstra 2006,28 the Netherlands, n=146Outpatient oncology. Breast cancerWeekly ratings in a paper bookletPatients were asked to bring the symptom monitor booklet to all clinical appointments.
Kravitz 2011,29–32 USA, n=307Outpatient oncology and palliative care. Recurrent or metastatic lung, breast, and upper gastrointestinal cancersQuestionnaire administered by telephone by a health educator on a single occasion prior to a clinic appointmentHealth educator met with patients an hour before clinic appointments and used their PROM data to provide tailored pain education, correcting misconceptions, teaching self-management strategies and how to communicate with the physician.
Kroenke 2010,33 USA, n=405Outpatient oncology. Mixed cancer typesAutomated telephone or online, twice weekly to monthly over 12 monthsNurse reviewed symptom reports, liaised with the patient's oncologist and contacted the patient with treatment recommendations.
Miaskowski 2004,34 USA, n=174 and Rustoen 2014,39 Norway, n=179 (PRO-SELF intervention)Outpatient oncology. Cancer with bony metastasesDaily paper diary for 6 weeksPROM data used to tailor education and coaching. Patients taught to use a weekly pill box, and to use a specific script to communicate with their physician about unrelieved pain and the need for a change in their medication.
Mooney 2014,35 USA, n=250Outpatient oncology. Mixed cancer typesDaily automated telephone assessment for 45 daysAutomated alerts faxed or emailed to the patient's oncologist or nurse if symptoms or trends in symptoms reached a threshold.
Post 2013,36 USA, n=50Outpatient oncology. Breast cancerWeekly on a PDA over 160 days.Patients asked to view videos on the PDA about how to communicate about symptoms and to bring the PDA to clinic appointments. Professionals viewed symptom summaries on the PDA and a printed output was added to clinic notes.
Ruland 2010,37 Norway, n=145 (CHOICE ITPA intervention)Inpatient and outpatient oncology. Haematological malignanciesPreclinic assessments and daily during inpatient admissions over 1 yearSymptom summaries printed and added to clinical notes to be reviewed by the treating physician
Trowbridge 1997,40 USA, n=510Outpatient oncology. Recurrent or metastatic cancerQuestionnaire immediately before a clinic appointmentSummary sheet provided to oncologist before the appointment
Vallières 2006,41 Canada, n=64Outpatient radiation oncology. Mixed cancer typesTwice daily paper diary at home for 3 weeksParticipants asked to bring their diary to scheduled clinic appointments. Participants asked to seek medical attention if pain intensity scores or analgesic use reached a predetermined threshold
Velikova 2004,42 UK, n=286Outpatient oncology. Mixed cancer typesTouch screen questionnaires in the waiting room before appointments for 6 monthsSpecific symptoms and functional outcomes were displayed individually and tracked longitudinally on graphs provided to the patient's physician.
Wilkie 2010,45 USA, n=215Outpatient oncology. Lung cancerGreased pencil on a laminated pain tool on a daily basisPatients watched a video on how to monitor and report changes in pain, and encouraged to summarise their pain ratings in note form to help them verbally report pain at scheduled appointments.
  • PDA, personal digital assistant; PROM, patient-reported outcome measurement.