Remote patient monitoring (RPM) in oncology: A systematic review.

597 Background: Patients with cancer experience a high symptom burden, which influences their quality of life (QOL) and care outcomes. RPM represents a novel tool to monitor and address patients’ symptoms and concerns in real-time and track their health status outside of the clinic. We conducted a systematic review to describe the literature focused on RPM in oncology. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) guidelines, we performed a comprehensive search using the OVID MEDLINE database for literature published from 1/1994 to 9/2024. We included randomized controlled trials (RCTs) focused on the utilization of RPM in oncology that enrolled patients 18 years or older with a cancer diagnosis. Using Covidence, two independent reviewers screened abstracts and conducted full-text reviews; a third reviewer resolved any disagreements. Results: Of 3,905 studies screened, 89 underwent full-text review, and we included 38 RCTs with 13,627 patients (median per study: 166.5 patients, range 33 to 2,793; age range: 18 to 93). Included studies were published between 2008 and 2024, with majority of studies (68%) published recently in 2020-2024, while 16% were published in 2008-2015 and 16% in 2015-2020. Most studies included patients with gastrointestinal cancers (71%), followed by breast (55%) and lung (50%) cancers. The most common type of RPM was web-based (50%), followed by mobile apps (34%) and telephone monitoring (21%). A small percentage of studies (11%) used an activity tracker (all published within the last 3 years), such as a wrist-worn biometric monitor to assess physical activity and vital signs. Primary outcomes included symptom severity (32%), QOL (18%), feasibility (18%), acceptability (8%), and depression/anxiety (8%). Secondary outcomes included QOL (42%), healthcare utilization (29%), and symptom severity (16%). Survival was a primary or secondary outcome in 21% of studies. Of the 38 RCTs, 83% of those assessing symptom burden and 48% of those evaluating health-related QOL met their endpoints. Studies examining survival and healthcare utilization met their outcomes in 25% and 23% of studies, respectively. Overall, 68% of studies met at least one of their primary outcomes. Conclusions: In this systematic review, we found 38 RCTs focused on RPM in adults with cancer. The types of RPM included web-based platforms, mobile-apps, and telephonemonitoring interventions. Notably, we found a small percentage of studies that utilized biometric monitoring to track activity and/or vital signs. We also found that over one-fifth of the studies measured survival as a primary or secondary outcome, while the majority focused on symptoms and QOL. Collectively, these findings highlight the rapid expansion of RPM research in oncology, marked by a recent surge in publications, a wide range of RPM modalities, and diverse endpoints focused on symptoms, QOL, and survival.