Putting it on the Line

Published: Thursday, Feb 26, 2009
A teenager finishes what she and her family hope will be the last in a series of chemotherapy treatments, and a celebratory trip to Disney World is underway. The teen feels a wave of nausea coming on while enjoying the festivities. She takes out her cell phone, text messages her nurse back home, and asks, “Is this a side effect of the chemo or the result of a ride on Space Mountain?” Scenarios like this are becoming more common for pediatric patients at Dana-Farber Cancer Institute’s Jimmy Fund Clinic. Whereas having a serious disease like cancer once tethered patients and their families close to home, now cell phones, personal digital assistants (PDAs), and other handheld digital devices are making it possible for patients and their families to take vacations far from home and enjoy other pleasures that were once denied by cancer.

E-mail communication between children with cancer and their caregivers, particularly nurses, is nothing new at the Jimmy Fund Clinic. Communication by cell phone has simply been the next step.

Even seemingly little things, like a pager for a parent dealing with an anxious, restless child in a waiting room, can improve the clinic experience for both patient and provider. “There’s often quite a bit of wait time to see a doctor or nurse when you get to the hospital,” says Dr. Marsha Fonteyn, a nurse scientist at the Dana-Farber Cancer Institute and member of the Oncology Nursing Society. “Parents of young patients or teenagers themselves are given a beeper, much like you’d get at a restaurant, and paged when it’s their turn. It works throughout the whole hospital, so they don’t have to stay in the waiting room.”

Between visits, cell phones have quickly become an integral—and popular—component of pediatric cancer care at the Jimmy Fund Cancer Clinic. “Patients typically call their nurses about symptom management and management of their side effects from chemotherapy,” Fonteyn says. “For example, if an older child was prescribed antibiotics and becomes immunocompromised, he or she can call the hospital and give details about what’s going on. We can then tell the patient whether he or she needs to come in or if a symptom is nothing to worry about. Or a parent of a child who suddenly starts exhibiting gastrointestinal symptoms like vomiting, diarrhea, or poor appetite can call and ask if it’s normal. You want them to be able to get in touch with you so they don’t run the risk of a possible complication that may cause their status to deteriorate.”

The success of the cell phone program at the Jimmy Fund Clinic was outlined by Annie Beauchemin, RN, BSN, CPON, and Robin O’Connell, RN, BSN, CPON, during a poster session at the 2005 National Conference of the Association of Pediatric Hematology/Oncology Nurses in Portland, OR. “For patients and families, the use of cell phones creates instant access to nurses, and preliminary feedback from patients and families indicates high levels of satisfaction with this method of communication,” they said. “For staff , using cell phones saves time and increases opportunities for direct interaction with patients and families.”

Cell phones also provide the immediacy of symptom reporting, which is often vital to clinical trials; about 95% of patients at the Jimmy Fund, according to Fonteyn, are enrolled in trials. “You want them to follow their regimen very closely. Instant reporting of side effects can impact the results of a clinical trial.”

Did you remember your medicine?

Perhaps one of the most obvious and immediate uses of cell phones in cancer patient care is as a pocket medication reminder. Proper adherence to medication dosage and schedule has a direct impact on the quality and efficacy of cancer care. Medication reminders not only help the patient, but also his or her home caregivers, who suddenly find themselves responsible for helping a loved one get through the challenge of cancer.

“The cell phone is ubiquitous today,” says John Maschenic, associate director for healthcare and head of sales and marketing for Verizon’s Pill Phone. “There’s one on every hip.” The Pill Phone is actually an application that can be downloaded to most cell phones, whether Verizon or another brand, for about $4 per month. It stores, updates, and provides photographs and generic conversions for roughly 1,800 prescription and OTC medications. It also offers a medication reminder feature, which allows users to schedule automatic reminders to take the right medicine at the right time. But as Maschenic discovered, caregivers are finding the feature to be extremely helpful as well.

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Community Practice Connections™: 18th Annual International Lung Cancer Congress®Oct 31, 20181.5
Clinical Interchange™: Translating Research to Inform Changing Paradigms: Assessment of Emerging Immuno-Oncology Strategies and Combinations across Lung, Head and Neck, and Bladder CancersOct 31, 20182.0
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