Physiological and psychological symptom management based on electronic patient-reported outcomes: the TD-WELLBEING randomized clinical trial

Abstract

One-third of all lung cancer cases globally are reported in China. This study evaluated the symptom management efficacy of an electronic patient-reported outcomes (ePRO)-based intervention for postoperative symptoms like pain and psychological distress after lung cancer surgery. We included lung cancer surgery patients (April 2022–October 2023; age, 18–75 years) with ECOG scores of 0–2 and expected survival of >6 months and randomized them into control and intervention groups. The latter completed MDASI-LC and QLQ-C30 questionnaires, wherein high symptom scores prompted treatment recommendations; the former received routine care. Changes in symptom scores, daily function, and quality of life were evaluated over 12 weeks and 1 year through surveys and interviews for ePRO-based symptom management efficacy assessments. Herein, 355 participants comprised intervention (n = 182) and control groups (n = 173). At 12 weeks, the former had significantly lower symptoms threshold [0 (0–1) vs. 1 (0–3)], lower symptom scores [adjusted mean difference, −0.527 (95% CI: −0.788 to −0.266)], and higher QOL scores (emotional function: 2.908; 95% CI: 0.600–5.216, P = 0.014; global health: 6.775; 95% CI: 3.967–9.583). ePRO-based collaborative management effectively lessened postoperative burden and improved QOL beyond 6 months.