Title | An eHealth system supporting palliative care for patients with non-small cell lung cancer: a randomized trial. |
Publication Type | Journal Article |
Year of Publication | 2013 |
Authors | Gustafson DH, DuBenske LL, Namkoong K, Hawkins R, Chih M-Y, Atwood AK, Johnson R, Bhattacharya A, Carmack CL, Traynor AM, Campbell TC, Buss MK, Govindan R, Schiller JH, Cleary JF |
Journal | Cancer |
Volume | 119 |
Issue | 9 |
Pagination | 1744-51 |
Date Published | 2013 May 01 |
ISSN | 1097-0142 |
Keywords | Adult, Aged, Carcinoma, Non-Small-Cell Lung, Caregivers, Humans, Internet, Lung Neoplasms, Middle Aged, Palliative Care |
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. |
DOI | 10.1002/cncr.27939 |
Alternate Journal | Cancer |
PubMed ID | 23355273 |
PubMed Central ID | PMC3684251 |
Grant List | P30 CA014520 / CA / NCI NIH HHS / United States P30 CA016672 / CA / NCI NIH HHS / United States P50 CA095817 / CA / NCI NIH HHS / United States |