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Electronic self-report assessment for cancer and self-care support: results of a multicenter randomized trial
Donna L Berry1, Fangxin Hong, Barbara Halpenny
1Donna L. Berry, Fangxin Hong, Barbara Halpenny, and Ann H. Partridge, Dana-Farber Cancer Institute; Donna L. Berry and Ann H. Partridge, Harvard Medical School, Boston, MA; Jesse R. Fann, Upendra Parvathaneni, Anthony L. Back, and Dagmar Amtmann, University of Washington Medical Center; Jesse R. Fann, Anthony L. Back, Dagmar Amtmann, and Rosemary Ford, Seattle Cancer Care Alliance; Seth Wolpin and William B. Lober, University of Washington, Seattle; and Nigel E. Bush, National Center for Telehealth and Technology, US Department of Defense, Joint Base Lewis-McChord, Tacoma, WA.
Purpose:
The purpose of this trial was to evaluate the effect of a Web-based, self-report assessment and educational intervention on symptom distress during cancer therapy.
Patients And Methods:
A total of 752 ambulatory adult participants were randomly assigned to symptom/quality-of-life (SxQOL) screening at four time points (control) versus screening, targeted education, communication coaching, and the opportunity to track/graph SxQOL over time (intervention). A summary of the participant-reported data was delivered to clinicians at each time point in both groups. All participants used the assessment before a new therapeutic regimen, at 3 to 6 weeks and 6 to 8 weeks later, completing the final assessment at the end of therapy. Change in Symptom Distress Scale-15 (SDS-15) score from pretreatment to end of study was compared using analysis of covariance and regression analysis adjusting for selected variables.
Results:
We detected a significant difference between study groups in mean SDS-15 score change from baseline to end of study: 1.27 (standard deviation [SD], 6.7) in the control group (higher distress) versus -0.04 (SD, 5.8) in the intervention group (lower distress). SDS-15 score was reduced by an estimated 1.21 (95% CI, 0.23 to 2.20; P = .02) in the intervention group. Baseline SDS-15 score (P < .001) and clinical service (P = .01) were predictive. Multivariable analyses suggested an interaction between age and study group (P = .06); in subset analysis, the benefit of intervention was strongest in those age > 50 years (P = .002).
Conclusion:
Web-based self-care support and communication coaching added to SxQOL screening reduced symptom distress in a multicenter sample of participants with various diagnoses during and after active cancer treatment. Participants age > 50 years, in particular, may have benefited from the intervention.
