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Peer-reviewedCC BY-NCCancer medicine

Development and Feasibility Evaluation of a Nurse-Led ePRO System for Home-Based Post-Chemotherapy Symptom Management in Patients With Cancer.

  • Chiao-Chi Kuan1,2
  • Jhe-Cyuan Guo3,4,5
  • Shan-Hsiang Shen6
  • Chiun Hsu3,4,5
  • Chi-Ming Chu7,8,9
  • Chi-Kang Lin10,11
  • Hsueh-Hsing Pan1,12,13
13 affiliations
  1. 1Graduate Institute of Medical Sciences, College of Medicine, National Defense Medical University, Taipei City, Taiwan.
  2. 2Department of Nursing, National Taiwan University Cancer Center, Taipei City, Taiwan.
  3. 3Department of Oncology, National Taiwan University Hospital, Taipei City, Taiwan.
  4. 4Department of Medical Oncology, National Taiwan University Cancer Center, Taipei City, Taiwan.
  5. 5Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei City, Taiwan.
  6. 6Department of Computer Science and Information Engineering, National Taiwan University of Science and Technology, Taipei City, Taiwan.
  7. 7College of Public Health, National Defense Medical University, Taipei City, Taiwan.
  8. 8Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
  9. 9Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
  10. 10Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical University, Taipei City, Taiwan.
  11. 11Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, National Defense Medical University, Taipei City, Taiwan.
  12. 12Department of Nursing, Tri-Service General Hospital, National Defense Medical University, Taipei City, Taiwan.
  13. 13College of Nursing, National Defense Medical University, Taipei City, Taiwan.
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Abstract

Background

Electronic patient-reported outcome (ePRO) systems support symptom monitoring after chemotherapy; however, their integration into structured nurse-led oncology workflows remains limited. In this study, we aimed to develop and evaluate the short-term feasibility and usability of a nurse-led ePRO system for home-based postchemotherapy symptom monitoring and structured nursing triage for cancer patients.Methods

This single-arm feasibility study was conducted at a cancer center in Taiwan between April and September 2024 among adult patients requiring home-based symptom monitoring after hospital-based chemotherapy care. The nurse-led digital system was designed to support weekly self-reporting of 12 chemotherapy-related symptoms using the Chemotherapy Toxicity Self-Assessment Questionnaire. The system incorporated rule-based triage categorization using green, orange, and red risk levels and predefined nurse response protocols. Feasibility outcomes included report adherence, triage alert management, and system performance. Usability was evaluated using the System Usability Scale.Results

Forty-two patients submitted 306 symptom reports during the 8-week monitoring period, corresponding to an overall adherence rate of 91.1%. Among all reports, 16.3% generated orange alerts requiring nurse follow-up and 6.5% generated red alerts requiring urgent review. Fatigue, pain, and hand-foot syndrome were the most frequently reported abnormal symptoms. All orange and red alerts had documented nursing review. The system met the predefined technical performance indicators during simulated load testing, and achieved a mean System Usability Scale score of 92.6 ± 6.46.Conclusions

This nurse-led ePRO system demonstrated favorable short-term feasibility and usability for home-based postchemotherapy symptom monitoring and structured nursing triage. These findings support the practicality of integrating structured ePRO monitoring into postchemotherapy nursing care. Further multicenter and comparative studies are warranted to evaluate long-term engagement, scalability, and clinical outcomes.

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Cite

BibTeXRIS
BibTeX
@article{kuan2026development,
  title = {{Development and Feasibility Evaluation of a Nurse-Led ePRO System for Home-Based Post-Chemotherapy Symptom Management in Patients With Cancer.}},
  author = {Chiao-Chi Kuan and Jhe-Cyuan Guo and Shan-Hsiang Shen and Chiun Hsu and Chi-Ming Chu and Chi-Kang Lin and Hsueh-Hsing Pan},
  journal = {Cancer medicine},
  year = {2026},
  month = oct,
  doi = {10.1002/cam4.72377},
  url = {https://europepmc.org/article/MED/42910562},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Development and Feasibility Evaluation of a Nurse-Led ePRO System for Home-Based Post-Chemotherapy Symptom Management in Patients With Cancer.
AU  - Chiao-Chi Kuan
AU  - Jhe-Cyuan Guo
AU  - Shan-Hsiang Shen
AU  - Chiun Hsu
AU  - Chi-Ming Chu
AU  - Chi-Kang Lin
AU  - Hsueh-Hsing Pan
PY  - 2026
DA  - 2026/10/01
JO  - Cancer medicine
DO  - 10.1002/cam4.72377
UR  - https://europepmc.org/article/MED/42910562
AB  - Background  Electronic patient-reported outcome (ePRO) systems support symptom monitoring after chemotherapy; however, their integration into structured nurse-led oncology workflows remains limited. In this study, we aimed to develop and evaluate the short-term feasibility and usability of a nurse-led ePRO system for home-based postchemotherapy symptom monitoring and structured nursing triage for cancer patients.Methods  This single-arm feasibility study was conducted at a cancer center in Taiwan between April and September 2024 among adult patients requiring home-based symptom monitoring after hospital-based chemotherapy care. The nurse-led digital system was designed to support weekly self-reporting of 12 chemotherapy-related symptoms using the Chemotherapy Toxicity Self-Assessment Questionnaire. The system incorporated rule-based triage categorization using green, orange, and red risk levels and predefined nurse response protocols. Feasibility outcomes included report adherence, triage alert management, and system performance. Usability was evaluated using the System Usability Scale.Results  Forty-two patients submitted 306 symptom reports during the 8-week monitoring period, corresponding to an overall adherence rate of 91.1%. Among all reports, 16.3% generated orange alerts requiring nurse follow-up and 6.5% generated red alerts requiring urgent review. Fatigue, pain, and hand-foot syndrome were the most frequently reported abnormal symptoms. All orange and red alerts had documented nursing review. The system met the predefined technical performance indicators during simulated load testing, and achieved a mean System Usability Scale score of 92.6 ± 6.46.Conclusions  This nurse-led ePRO system demonstrated favorable short-term feasibility and usability for home-based postchemotherapy symptom monitoring and structured nursing triage. These findings support the practicality of integrating structured ePRO monitoring into postchemotherapy nursing care. Further multicenter and comparative studies are warranted to evaluate long-term engagement, scalability, and clinical outcomes.
SN  - 2045-7634
ER  -