Towards safer delivery and monitoring of cancer treatments. Electronic patient self-Reporting of Adverse-events: Patient Information and aDvice (eRAPID).

Aims and Objectives eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) will develop and evaluate a system for patients to self-report adverse events (AE) during and after cancer treatments. It will be electronic, allowing AE-reporting from home/hospitals; integrated in routine care by documenting AE in existing Electronic-Patient-Records, generating alerts for severe AE and providing patient advice on mild AE. The overall aims are to improve the safe delivery of cancer treatments, enhance patient care/experiences and standardise documentation of AE within the clinical datasets. Background and rationale Over 250,000 patients in the UK are diagnosed with cancer each year. All cancer treatments have acute and long-term AE. An estimated 1.8 million people are living with and beyond cancer. Improving AE reporting/ documentation during and after cancer treatment can improve patient care through earlier detection/timely management of AE, directing patient to appropriate services for late-radiotherapy effects, supporting patients post-discharge after cancer surgery. However, a feasible, cost-effective and sustainable model is required. Information technology offers potential solutions for remote- monitoring, but there is a need for applied research to develop and evaluate such approach. Research plan We have a coherent and integrated programme of work that will develop and test the eRAPID intervention in: systemic treatment (chemotherapy and targeted therapies), radiotherapy for pelvic malignancies surgery for upper gastro-intestinal cancer The programme is organised in 5 work-packages (WP) applied across the clinical areas. Work-packages 1 to 3 comprise the development of eRAPID intervention. WP1 Electronic platform. Implement a secure flexible electronic platform for patients to report AE from clinic and home, with real-time AE documentation in Electronic-Patient-Records. WP2 Patients: AE items and advice. Develop patient-reported AE items, with defined severity grades and evidence-based patient advice and alerts. WP3 Professionals and care pathways. Understand and map the current patient pathways aiming to integrate eRAPID and identify key professionals to be trained in its delivery. On completion of the above, the eRAPID intervention model will be developed, ready for testing. WP4 Feasibility and pilot studies. Pilot eRAPID assessing patient /clinician feasibility and acceptability. WP5 Large Scale Evaluation: Undertake a randomised-controlled-trial to establish clinical and cost-effectiveness of eRAPID in Systemic-Treatment. Projected outputs We ll deliver a secure electronic platform suitable for online patient self-reporting, integrated with Electronic-Patient-Records that can support innovative models of patient-care in cancer and non-cancer settings. All clinical areas will deliver a tested eRAPID package for AE-monitoring and management during/after cancer treatments, based on online AE-reporting, with a tested self-management advice for mild/moderate symptoms and hospital-alerts for severe AE. In Systemic-Treatments our programme will provide evidence that allows commissioning and implementation of the eRAPID package (supported by a dissemination toolkit). In radiotherapy eRAPID we will fill-in the existing gap in collecting late-effects data, provide appropriate patient support and start building clinical-databases on radiotherapy late-effects. In upper-GI-surgery, we ll start building the evidence on whether it is feasible to use eRAPID in supporting patients post-surgery. Dissemination We will undertake structured consultations with key partners involved in the delivery and commissioning of cancer treatments. We will work closely with our Steering-Committee, National-Cancer-Action-Team, NHS commissioners and national clinical leads for cancer services to ensure our findings are transferable, inform policy and