An eHealth system supporting palliative care for patients with non–small cell lung cancer: A randomized trial. Issue 9 (25th January 2013)

• Record Type: Journal Article
• Authors: Gustafson, David H.; DuBenske, Lori L.; Namkoong, Kang; Hawkins, Robert; Chih, Ming‐Yuan; Atwood, Amy K.; Johnson, Roberta; Bhattacharya, Abhik; Carmack, Cindy L.; Traynor, Anne M.; Campbell, Toby C.; Buss, Mary K.; Govindan, Ramaswamy; Schiller, Joan H.; Cleary, James F.
• Is Part Of: Cancer. Volume 119:Issue 9(2013)
• Page Start: 1744
• Page End: 1751
• Publication Date: 2013-01-25
• Subjects: lung cancer -- symptom distress -- palliative care -- quality of life -- survival -- eHealth -- communication and information technology; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.27939
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract: BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non–small cell lung cancer (NSCLC). METHODS: In total, 285 informal caregiver‐patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks were optional. The primary endpoint—patient symptom distress—was measured by caregiver reports using a modified Edmonton Symptom Assessment Scale. RESULTS: Caregivers in the CHESS arm consistently reported lower patient physical symptom distress than caregivers in the Internet arm. Significant differences were observed at 4 months ( P = .031; Cohen d = .42) and at 6 months ( P = .004; d = .61). Similar but marginally significant effects were observed at 2 months ( P = .051; d = .39) and at 8 months ( P = .061; d = .43). Exploratory analyses indicated that survival curves did not differ significantly between the arms (log‐rank P = .172), although a survival difference in an exploratory subgroup analysis suggested an avenue for further study. CONCLUSIONS: The current results indicated that an online support system may reduce patient symptom distress. The effect on survival bears further investigation. Cancer 2013. © 2013 American Cancer Society. Abstract : Patients in caregiver‐patient dyads who are randomized to an eHealth system that supports palliative care (Comprehensive Health Enhancement Support System [CHESS]) for non–small cell lung cancer have significantly less physical symptom distress compared with patients in similar dyads from an Internet arm.