Could home-based monitoring enhance your cancer care?

Imagine if you could monitor your health between clinic visits and quickly share the details with your care team.

That's the premise of research that's being conducted here.

"We're looking at new ways of data collection that are grounded in real-world challenges," explains Susan Peterson, Ph.D., in Behavioral Science.

This may help address health issues and behaviors that change when you you're not at the hospital or your doctor's office. For example, patients with head and neck cancer usually don't develop swallowing difficulties while they're at their doctors' offices. And former smokers may not struggle with relapse while they're sitting in clinic waiting rooms.

So our researchers are looking at ways to use modern technology to monitor patients' vital signs, side effects, symptoms and treatment adherence between medical appointments.

Research that's based in reality

In their first study, the researchers tested the use of mobile sensors like fitness trackers and other portable devices that enable patients to monitor their health at home. The study was conducted by researchers from MD Anderson, the University of Alabama at Birmingham and the University of California, San Diego.

Researchers created a system that used mobile applications to gather daily data from patients and send the information to their health care teams. The system, called CYCORE (CYberinfrastructure for COmparative effectiveness REsearch), enables patients to directly enter their personal health information into various devices.

"Using CYCORE, we've been able to gather behavioral, environmental and psychological data that's typically not collected in research trials," Peterson says.

Different cancers, different issues

The cancer survivors who took part in this study fell into one of three groups. Approximately 50 patients had colon cancer, 50 had a variety of cancers and were former smokers who had completed our Tobacco Treatment Program, and 80 had head and neck cancer.

"We chose these groups because they demonstrated challenging, actual problems in cancer prevention and treatment," Peterson explains.

Each patient was monitored for two weeks, and individual data was sent, often via wireless Bluetooth device, to a small computer in the patient's home that was linked to a central database. CYCORE's interfaces enabled doctors, researchers and patients to track data and view trends.

The patient's cancer type determined the kind of information collected. Physical activity is crucial for both quality of life and survival of patients with colon cancer, Peterson says. So the researchers captured these patients' levels of physical activity using mobile devices that included heart rate monitors, portable global positioning systems, accelerometers and smartphones.

To find out if the patients who were former smokers were remaining tobacco-free, the researchers asked them to breathe three times a day into hand-held carbon monoxide monitors that detected if they'd been smoking.

The patients with head and neck cancer were asked to use their mobile devices and smartphones each weekday of the study to measure their weight and vital signs. They also answered a series of questions about their current symptoms, like pain and lightheadedness. This information was electronically transmitted to their treatment team each day, allowing close monitoring for signs of dehydration or malnutrition.

But would they do it?

Our researchers wanted to make sure that the home-based monitoring was something that patients and caregivers would actually use.

All study participants completed multiple questionnaires that assessed ease of use and general satisfaction with the devices. Overall, responses were favorable, Peterson reports.

"The study completion rates across all three groups were generally high," she says. "And the participants gave uniformly high ratings to the usability and acceptability of the mobile devices for at-home monitoring."

Getting support from our doctors, such as Beth Beadle, M.D., Ph.D., in Radiation Oncology, was equally important to the success of this research.

"The CYCORE data sent me key information about the patients every day," Beadle says. "I could see if they were losing weight, had uncontrolled pain or signs of dehydration. In those cases, I could have them come in, order new medications or order IV hydration before it becomes an emergency. Overall, the CYCORE information is a wonderful addition to our clinical practice and puts me in better touch with the patients during treatment."

This is good news for our patients, as researchers plan to continue this study and expand CYCORE. "Our goal is to make it adaptable to future technologies and responsive to future needs inside and outside MD Anderson," Peterson says.

A longer version of this story originally appeared in Messenger, MD Anderson's bimonthly publication for employees.