Over 250,000 patients in the UK are diagnosed with cancer each year. All cancer treatments have acute and long-term Adverse Effects(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 patients to appropriate services for late-radiotherapy effects and 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 approaches.
Aims and Objectives
eRAPID is a 5 year multi-centre research programme funded by the National Institute for Health Research (NIHR). The research will be carried out in three hospital sites; Leeds, Bristol and Manchester. During the programme a new online system to improve the monitoring and management of symptoms and side effects related to cancer treatment (chemotherapy, radiotherapy and surgery) will be evaluated. The online reports are immediately displayed in the patient hospital electronic records, so clinicians can use them to improve and streamline patient care. This is a truly unique feature of the eRAPID system. The aim of eRAPID is to improve the safe delivery of cancer treatment, enhance the patient experience and care and to standardise documentation of symptoms and side effects of treatments.
The programme of work 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 the 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.
Partners & Collaborators
PI: Galina Velikova (Medical Oncology and Patient-reported Outcomes)
Julia Brown (Clinical Trials, Leeds)
Jenny Hewison (Health Services Research, Leeds)
Claire Hulme (Health Economics, Leeds)
Barbara Potrata (Qualitative research)
Richard Jones (Health Informatics, Leeds)
Jane Blazeby (Surgical Oncology, Bristol)
Kevin Franks (Clinical Oncology & Radiotherapy, Leeds)
Geoff Hall (Medical Oncology, Cancer Lead Clinician and IT, Leeds)
Martin Waugh (Health Informatics, PPM, Leeds)
Foluke Ajayi (NHS Manager for Oncology, Leeds)
Clare Harley (Patient-Reported Outcomes, Leeds)
Peter Selby (Medical Oncology, Leeds; Association of Cancer Physicians)
Susan Davidson (Clinical Oncology, Manchester)
Krystina Kozlowska (Lead Cancer Nurse, Leeds)
Carolyn Morris- Patient representative
Funding agency: National Institute for Health Research (NIHR) Programme Grant
Grant value: £1,969,062.00
Project period: 2013-2017