Deployment of remote patient monitoring in older patients: A real-world experience from 2419 patients across 58 centres in France and Belgium

BackgroundRemote patient monitoring (RPM) using electronic Patient Reported Outcomes (ePROs) offers an opportunity to detect earlier, in the health-care pathway, actionable symptoms commonly experienced by patients undergoing anticancer therapy. RPM demonstrated effectiveness in reducing morbidity, while improving quality of life through multiple phase 3 trials. Therefore, the European Society for Medical Oncology (ESMO) recommended the use of RPM based on ePROs in routine care in the 2022 clinical practice guidelines. However, the implementation, the patient adherence, and the benefits of RPM in older patients remain largely unknown.MethodsIn this retrospective multicenter cohort study, data from patients aged 65 or older and included in the RPM solution between January 2022 and November 2023 in 58 French and Belgium centers was analysed. The RPM pathway includes four steps: (i) medical prescription, (ii) patients onboarding by a nurse, (iii) weekly collection of tailored symptoms survey (PRO-CTCAE) (iv) alert notification to the care team when severe (grades 3-4) PRO-CTCAE or worsening symptoms (moving from a grade 0 to 2) PRO-CTCAE. The main endpoint was adherence of patients to the weekly questionnaire at 3 and 6 months. Secondary endpoints were symptoms assessment and clinical benefits (assessed by symptoms improvement).ResultsA total of 2419 patients were included in 58 healthcare centres in France and Belgium (median age:74; min:64; max=96; 56% women). The most prevalent cancer types were gastrointestinal (30%), breast (27%), genitourinary (13%), thoracic (7%), gynecologic (7%) and hemato-oncology (6%). At 3 and 6 months, 82% of patients adhered to the weekly questionnaires. The most frequent grade ≥ 2 symptoms at 6 months were pain (66%), diarrhea (50%), nausea (49%). After the alerts, assessment of symptoms within two weeks showed a proportion of 96% improvement of at least 1 point and 83% improvement of 2 to 3 points in PRO-CTCAE.ConclusionsThe implementation of RPM pathway in routine care for older patients is feasible, has clinical benefits and high level of adherence. These findings reinforce the importance of integrating RPM in older patients as a standard of care in routine practice.Legal entity responsible for the studyResilience care.FundingHas not received any funding.DisclosureT. Grellety: Financial Interests, Personal, Advisory Board: AstraZeneca, Pfizer, Novartis, Lilly, Roche. M. Autheman: Financial Interests, Personal, Other, Employee: Resilience Care. E.G.C. Brain: Financial Interests, Personal, Invited Speaker, Webinars, optimized endocrine therapy for older breast cancer patients: Eli Lilly; Financial Interests, Personal, Advisory Board, Palbociclib and older breast cancer patients: Pfizer; Financial Interests, Personal, Invited Speaker, Symposium HER2+ MAO conference 03/21: SEAGEN; Financial Interests, Personal, Invited Speaker, ELEVATE 10/2021 and ABC 11/2021 meeetings: Pfizer; Financial Interests, Personal, Other, IDMC DESTINY 05: DAIICHI; Financial Interests, Personal, Advisory Board, GCSF and FN in older patients: Sandoz; Financial Interests, Personal, Advisory Board, Underserved Patients Populations with breast cancer, advisory board: Pfizer; Financial Interests, Personal, Invited Speaker, Management of older patients with cancer, series of seminars in Canada for HCP: Pfizer; Financial Interests, Personal, Invited Speaker, Symposium during SIOG annual meeting 1/11/2023: Daiichi; Financial Interests, Personal, Invited Speaker, RWD in myeloma and older patients, Prohgress, 17/11/2023: Takeda; Financial Interests, Personal, Invited Speaker, TIBCS, taipei, older patienst with breast cancer, 21/09/2023: Pfizer; Financial Interests, Personal, Invited Speaker, Series of lectures in Montreal/Quebec on breast cancer management in older ones, 09-13/10/2023: Pfizer; Financial Interests, Personal, Advisory Board, Elacestrant and BC, 13/03/2023: Menarini; Financial Interests, Personal, Invited Speaker, 29/03/2023 symposium during SFH annual meeting, RWD and older patients: Incyte; Financial Interests, Personal, Invited Speaker, Patients pathways for nurse practioners: AstraZeneca; Financial Interests, Institutional, Coordinating PI, APPALACHES study EORTC 1745: Pfizer; Financial Interests, Institutional, Coordinating PI, TOUCH study (IBCSG 55/GERICO study): Pfizer; Financial Interests, Institutional, Local PI, DEESTINY 09: Daiichi Sankyo; Financial Interests, Institutional, Local PI, DESTINY 06: Daiichi Sankyo; Financial Interests, Institutional, Local PI, SERENA 06: AstraZeneca; Non-Financial Interests, Member of Board of Directors, General secretary: EORTC; Non-Financial Interests, Member of Board of Directors: SIOG, BIG; Non-Financial Interests, Member of Board of Directors, treasurer: EBCC. L. Mourey: Financial Interests, Personal, Advisory Board: Astellas, Janssen, MSD, BMS, Ipsen, AstraZeneca, Pfizer, AAA. M. Frelaut: Financial Interests, Personal, Advisory Board: Sandoz; Financial Interests, Personal, Invited Speaker: MSD; Financial Interests, Institutional, Coordinating PI: IPSEN; Non-Financial Interests, Advisory Role: SOFOG, EORTC, INCA; Non-Financial Interests, Member: EORTC, ASCO, SOFOG. A. Couderc: Financial Interests, Personal and Institutional, Speaker, Consultant, Advisor: BMS, Ferring, Nutricia, Amgen, Sanofi, GSK. F. Canouï-Poitrine: Financial Interests, Personal, Invited Speaker, Invited Speaker : the advanced Practice Nurses: Viatris. C. Baldini: Financial Interests, Personal and Institutional, Speaker, Consultant, Advisor: Rising Tide Fundation, Boxer Capital, EcoR1 capital, MSD, GSK, BMS, AZ, Amgen; Non-Financial Interests, Personal and Institutional, Speaker, Consultant, Advisor: Elaia Partners; Financial Interests, Personal and Institutional, Advisory Board: Janssen; Non-Financial Interests, Institutional, Local PI: Janssen, Genmab, Tango, MSD, Bicycle therapeutics, Artios, Roche, Adlai Nortye, Iteos, Tahio. All other authors have declared no conflicts of interest.