Psychological mobile app for patients with acute myeloid leukemia: A pilot randomized clinical trial. Issue 7 (18th January 2023)

• Record Type: Journal Article
• Authors: El‐Jawahri, Areej; Luskin, Marlise R.; Greer, Joseph A.; Traeger, Lara; Lavoie, Mitchell; Vaughn, Dagny Marie; Andrews, Stephanie; Yang, Daniel; Boateng, Kofi Y.; Newcomb, Richard A.; Ufere, Nneka N.; Fathi, Amir T.; Hobbs, Gabriela; Brunner, Andrew; Abel, Gregory A.; Stone, Richard M.; DeAngelo, Daniel J.; Wadleigh, Martha; Temel, Jennifer S.
• Is Part Of: Cancer. Volume 129:Issue 7(2023)
• Page Start: 1075
• Page End: 1084
• Publication Date: 2023-01-18
• Subjects: acute myeloid leukemia (AML) -- leukemia -- mobile health -- psychological mobile app -- quality of life; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.34645
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract: Background: Patients with acute myeloid leukemia (AML) experience a substantial decline in quality of life (QoL) and mood during their hospitalization for intensive chemotherapy, yet few interventions have been developed to enhance patient‐reported outcomes during treatment. Methods: We conducted a pilot randomized trial (ClinicalTrials.gov identifier NCT03372291) of DREAMLAND, a psychological mobile application for patients with a new diagnosis of AML who are receiving intensive chemotherapy. Patients were randomly assigned to DREAMLAND or usual care. DREAMLAND included four required modules focused on: (1) supportive psychotherapy to help patients deal with the initial shock of diagnosis, (2) psychoeducation to manage illness expectations, (3) psychosocial skill‐building to promote effective coping, and (4) self‐care. The primary end point was feasibility, which was defined as ≥60% of eligible patients enrolling and 60% of those enrolled completing ≥60% of the required modules. We assessed patient QoL (the Functional Assessment of Cancer Therapy–Leukemia), psychological distress (the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire‐9), symptom burden (the Edmonton Symptom Assessment Scale), and self‐efficacy (the Cancer Self‐Efficacy Scale) at baseline and at day 20 after postchemotherapy. Results: We enrolled 60 of 90 eligible patients (66.7%), and 62.1% completed ≥75% of the intervention modules. At day 20 after chemotherapy, patients who were randomized to DREAMLAND reported improved QoL scores (132.06 vs. 110.72; p =.001), lower anxiety symptoms (3.54 vs. 5.64; p = .010) and depression symptoms (Hospital Anxiety and Depression Scale: 4.76 vs. 6.29; p = .121; Patient Health Questionnaire‐9: 4.62 vs. 8.35; p < .001), and improved symptom burden (24.89 vs. 40.60; p = .007) and self‐efficacy (151.84 vs. 135.43; p = .004) compared with the usual care group. Conclusions: A psychological mobile application for patients with newly diagnosed AML is feasible to integrate during hospitalization for intensive chemotherapy and may improve QoL, mood, symptom burden, and self‐efficacy. Abstract : A psychological mobile application for patients with newly diagnosed acute myeloid leukemia (AML) is feasible to integrate during hospitalization for intensive chemotherapy. The mobile application has promising preliminary efficacy for improving quality of life, mood, symptom burden, and self‐efficacy for patients with AML.