基于网络的癌症症状自我管理系统:一项随机临床试验
David Cella1, Nicola Lancki2, Maja Kuharic1
1Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA network open
|May 5, 2025
概括
将双语网络自主管理程序添加到电子健康记录 (EHR) 集成的患者报告结果 (cPRO) 中,并没有减少癌症患者的症状负担或医疗资源使用 (HCRU). 参与度低表明需要改进干预策略.
科学领域:
- 在瘤学瘤学.
- 数字健康数字健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 癌症患者和癌症幸存者经常经历严重的症状负担,影响生活质量和增加医疗保健利用率.
- 有效的症状管理对于以患者为中心的癌症护理至关重要.
研究的目的:
- 评估一项双语 (英语/西班牙语) 基于网络的自我管理计划,加上电子健康记录 (EHR) 集成的患者报告结果 (cPRO) 评估,是否可以减少癌症患者的症状负担和医疗资源使用 (HCRU).
- 评估增强护理 (EC) 与常规护理 (UC) 在管理癌症症状和资源利用方面的有效性.
主要方法:
- 一个患者级随机临床试验,涉及30家诊所的1614名成人癌症患者和幸存者.
- 参与者可以通过EHR集成的cPRO获得常规护理 (UC),也可以通过添加基于Web的自我管理计划获得增强护理 (EC).
- 结果包括12个月的患者报告结果测量信息系统 (焦虑,抑郁,疲劳,疼痛,身体功能) 和HCRU (住院访问,ED访问,医院日) 的措施.
主要成果:
- 对于12个月的CPRO结果,在增强护理 (EC) 和常规护理 (UC) 组之间没有观察到统计学上显著的差异.
- 医疗保健资源利用率 (HCRU) 在EC和UC组之间也没有显著差异.
- 网站的参与度很低,只有52.1%的用户访问了该程序,而47%的用户返回,平均每次访问花费45秒.
结论:
- 将双语基于网络的自我管理程序添加到EHR集成的cPRO中,并没有显著减少该患者群体的症状负担或HCRU.
- 基于网络的干预的低参与度凸显了制定改善参与和定制数字健康工具以获得最大益处的战略的关键需求.
- 需要进一步的研究来优化癌症症状管理的数字干预措施,并减少医疗保健资源的使用.
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