Text-Messaging Prescreening Streamlines Treatment Visits and Care for ICI Toxicities

January 11, 2023 by Elisa Becze BA, ELS, Editor

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 (https://doi.org/10.1001%2Fjamanetworkopen.2022.28452) 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 (https://doi.org/10.1001%2Fjamanetworkopen.2022.28452) 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 (https://doi.org/10.1001%2Fjamanetworkopen.2022.28452) 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 (https://doi.org/10.1001%2Fjamanetworkopen.2022.28452). “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.”

Listen to strategies for educating your patients about reporting toxicities on the Oncology Nursing Podcast (https://www.ons.org/podcasts/episode-80-patients-need-checkpoint-inhibitor-education), and find other ICI and immunotherapy resources in ONS’s Immuno-Oncology Learning Library (https://www.ons.org/learning-libraries/immuno-oncology-immunotherapy).

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