Impact of feedback from Real-time, electronic symptom monitoring on post-discharge recOvery after Surgery for oEsophago-gastric cancer: a multi-centre randomised controlled trial

Aim

To find out if patients recovering at home from surgery for oesophago-gastric (food pipe or stomach) cancer benefit from electronic (online/web-based) symptom management information.

Background

Around 13,500 people in England and Wales are diagnosed with oesophago-gastric cancer each year, of which around 5,000 (40%) have major surgery. Patients stay in hospital for around 1-2 weeks after surgery. Even when well enough to continue their recovery at home, patients may still experience surgery-related problems or feel unwell with symptoms such as pain or tiredness. There is growing evidence from patients undergoing other treatments, such as chemotherapy, that electronic (online/web-based) symptom reporting can improve patients’ wellbeing by providing patients with information about how best to manage symptoms. However, this has not been studied in patients undergoing surgery for oesophago-gastric cancer.

Design and methods

206 patients undergoing surgery for oesophago-gastric cancer at six NHS hospitals in England will take part. Patients will be randomly placed in one of two groups. Patients in the ‘ROSE tool’ group will be asked to report their symptoms using an electronic (online/web-based) information tool while also receiving their usual care. Depending on the seriousness of reported symptoms, the ROSE tool will provide information about how to manage these symptoms and/or inform them to contact their healthcare team. Patients in the ‘usual care’ group will receive their usual clinical care and will not use the ROSE tool to complete the symptom-report questionnaire or to receive symptom management information.

All patients will complete additional questionnaires during the study, including before their surgery, when ready for discharge home and at several timepoints up to four weeks after going home from hospital. Some of these questionnaires will be completed electronically (online). We will use the questionnaire answers to see if patients in the ‘electronic information tool’ group have a better recovery from their surgery than those in the usual care group. We will also look at whether the electronic information tool is good value for money for the NHS.

Patient and public involvement

We have worked closely with patients and members of the public to develop the study, including choosing the questionnaires and deciding how many times patients will complete them. We will continue to work with patients and members of the public during the study, for example asking them what information should be included in participant study information leaflets.

Communicating study findings

We will share our study findings with the NHS and by publishing in scientific journals and presenting at scientific meetings. We will work with patient groups and professional organisations to make sure our findings are shared widely and explained in ways that everyone can understand.

Funding

The ROSE study is funded by the National Institute for Health Research (NIHR) Research for Patient Benefit (project number NIHR201483).

Contact details

The Chief Investigator for ROSE is Associate Professor Kerry Avery. The ROSE study team can be contacted by email at rose-study@bristol.ac.uk