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Electronic monitoring questionnaires did not significantly change time to pharmacist intervention in intent-to-treat analysisElectronic Monitoring May Help Manage Side Effects of Anticancer Drugs

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Key Takeaway
Note that while ITT analysis showed no significant difference, responders to electronic monitoring had faster interventions.

This randomized controlled trial enrolled 446 patients initiated on oral anticancer therapy, with 388 analyzed (183 intervention; 205 usual care). The intervention group received electronic monitoring via questionnaires 7 to 14 days after initial counseling. The primary outcome was the time to first adverse event-related pharmacist intervention.

In the intent-to-treat analysis, there was no significant difference in time to intervention (HR 1.2; P = 0.360) or intervention frequency (OR 1.2; P = 0.409) between groups. However, a per-protocol analysis of 291 patients showed significantly faster time to intervention for responders (HR 2.4; P < 0.001) and more frequent interventions (OR 2.7; P < 0.001). Additionally, these responders showed lower healthcare utilization (OR 0.4; 95% CI, 0.2-0.9; P = 0.023).

Safety data were not reported. A major limitation of the study was a low questionnaire response rate of 47%. While per-protocol results suggest that electronic monitoring may improve intervention timing and reduce healthcare utilization for patients who complete the questionnaires, the lack of significance in the intent--to-treat analysis suggests limited broad clinical impact.

Researchers conducted a randomized trial to see if using electronic questionnaires could improve care for patients starting oral anticancer medications. The study involved 388 patients who were split into two groups: one receiving the electronic monitoring and another receiving standard care.

The results showed that while the overall group did not show significant differences in intervention timing, a specific subset of patients who completed the questionnaires saw different results. For these responders, the electronic system led to faster pharmacist interventions and more frequent check-ins. These patients also had lower rates of healthcare utilization compared to those who did not use the system.

It is important to note that the study had a low response rate for the questionnaires. Because the positive results were only seen in the group that completed the surveys, it is unclear if this method works for everyone. Patients should talk to their doctors about how electronic monitoring might fit into their specific treatment plan.

What this means for you:
Electronic monitoring may lead to faster pharmacist intervention and lower healthcare use for some patients.

Common questions

How does electronic monitoring work for cancer patients?

Patients receive electronic questionnaires about 7 to 14 days after their initial counseling. These tools are designed to help pharmacists identify issues more quickly. For the group of patients who completed these surveys, the system led to significantly faster interventions and more frequent pharmacist check-ins.

Can this method reduce the need for extra healthcare visits?

The study found that among the patients who responded to the electronic questionnaires, there was a lower rate of healthcare utilization. This suggests that proactive monitoring might help manage issues before they require more intensive medical resources.

Is this method effective for all patients on anticancer drugs?

The results were mixed depending on how the data was analyzed. While the overall study did not show a significant difference between groups, those who completed the questionnaires saw better outcomes. Because of a low response rate, it is unclear if it works for everyone.

Study Details

Study typeRct
Sample sizen = 291
EvidenceLevel 2
Follow-up720.0 mo
PublishedAug 2026
View Original Abstract ↓
PURPOSE: This study evaluated the effectiveness of electronic early oral anticancer medication monitoring questionnaires in identifying adverse effects (AEs) requiring pharmacist intervention among patients initiated on oral anticancer therapy. METHODS: A prospective randomized study was conducted within an integrated health system specialty pharmacy. Patients were excluded if they never started treatment, discontinued oral anticancer therapy within 14 days, were not new to therapy, or had a hematologic condition. Stratified randomization by age (≥60 years versus <60 years) and sex was performed to assign patients to intervention or usual care. Intervention patients received an electronic questionnaire 7 to 14 days after initial counseling. Outcomes included time to first AE-related pharmacist intervention and intervention frequency within 45 days and dose modifications, healthcare utilization, and treatment modifications within 90 days. Per-protocol analysis compared outcomes among questionnaire responders and patients assigned to usual care. Cox proportional hazard (time to intervention) and ordinal logistic regression (intervention number) models adjusted for age, sex, race, diagnosis, Charlson comorbidity index score, and medication type. RESULTS: Of the 446 patients randomized, 388 were included in the analysis (183 in the intervention cohort and 205 in the usual care cohort). The questionnaire response rate was 47%. In the intent-to-treat analysis, no significant differences were observed in time to intervention (hazard ratio [HR], 1.2; P = 0.360) or intervention frequency (odds ratio [OR], 1.2; P = 0.409). Per-protocol analysis (n = 291) showed responders had significantly faster time to intervention (HR, 2.4; P < 0.001), more interventions (OR, 2.7; P < 0.001) and lower healthcare utilization (OR, 0.4; 95% CI, 0.2-0.9; P = 0.023). CONCLUSION: Electronic monitoring resulted in earlier and more frequent interventions and less healthcare utilization among questionnaire responders.
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