Prescreening patients for immune-related adverse events during treatment with immune checkpoint inhibitors (ICIs) using text messaging may reduce the need for some in-person, preinfusion office visits, researchers reported in JAMA Network Open. The approach may help decrease the burden of cancer care for both patients and providers.
In a single-center, cross-sectional study, researchers compared use of a text message–based triage instrument to identify patient-reported ICI toxic effects to standard in-person clinician assessments documented in patients’ electronic health record. Of the 45 patients who completed the text-message prescreening, 31 (62%) were male and 44 (88%) were White, and their median age was 68.
A total of 57.8% of the patients reported ICI toxic effects through the text-messaging prescreening. The instrument had 100% sensitivity with a 0% false-negative rate, 47% specificity, and 100% negative predictive value. The most common barriers limiting patients’ ability to complete the text-messaging prescreening were visual impairments and access to a smartphone.
“We show in this cross-sectional study that a simple text message–based questionnaire can accurately identify patients who are not experiencing symptoms of ICI toxic effects,” the researchers wrote. “This implies that such patients with normal laboratory parameters can likely bypass the usual pretreatment office visit and proceed directly to ICI infusion with minimal risk of missing an immune-related adverse event, which offers the potential to reduce up to 20% of office visits.”