Digital symptom monitoring using Careology at Guy’s and St Thomas’ NHS Foundation Trust (GSTFT).

Abstract

e13715 Background: Careology is a digital health platform for cancer patients receiving Systemic Anti-Cancer Therapy, enabling real-time toxicity reporting to healthcare teams. Patients grade symptom severity using the embedded UK Oncology Nursing Society red/amber/green triage system. Those reporting red or two amber symptoms are signposted to GSTFT’s 24-hour Acute Oncology Service (AOS). Operational staff monitor the Careology dashboard and proactively follow up to triage patients to appropriate services such as AOS or ED. Patients with mild symptoms can access Boots Macmillan Information Pharmacists for advice and prescriptions. This study reports anonymised real-world usage and downstream clinical impact. Methods: A retrospective analysis was conducted using anonymised data from 881 Careology users at GSTFT between July 2024 and December 2025. Outcomes for patients reporting red or multiple amber symptoms were extracted from electronic health records to assess downstream impact. Patient experience was evaluated via a feedback session and satisfaction survey. Results: Careology was rolled out at GSTFT, one of the UK’s largest tertiary cancer centres, in July 2024. Since deployment, 881 patients registered, including those with upper and lower GI (23.4%), breast (19.4%), and gynaecological cancers (11.1%). The most reported toxicities were fatigue (13.9%), pain (11.9%), and nausea (10.2%). Feature engagement increased over time, with symptom, mood and medication tracking, and educational content most used. In a patient focus group, one participant taking 40 daily medications described Careology as “absolutely brilliant for medication reminders.” From the satisfaction survey (n = 35), 80% would recommend Careology, 75.8% felt more in control of their care, and 84.4% felt clinician access to Careology data would be beneficial. Between July 2024 and October 2025, 273 patients reported at least one red or two amber symptoms. In this group, the most prevalent diagnoses were breast (24.5%), gynaecological (15.4%), and lung cancer (12.8%); the most reported symptoms are detailed in Table 1. Outcomes included clinician review (17.7%), in-person assessment (8.9%), ED attendance or advice to attend ED (7%), AOS referral (19.6%), no further action following discussion (11.1%), and hospital admission (6.6%). Conclusions: Digital symptom monitoring using Careology enabled proactive outreach, timely escalation, and improved toxicity management and patient experience at GSTFT. Further integration into routine consultant and nursing workflows may enhance early identification of high-risk toxicities and improve visibility of patient health between visits. Most reported symptoms by patients logging a red or at least two amber symptoms. Red symptoms Amber symptoms Pain (17.7%) Fatigue (15%) Neurosensory issues (14.8%) Neurosensory issues (10.7%) Fever (14.3%) Pain (10.5%)