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Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting

Steel, JL and Geller, DA and Kim, Kevin H and Butterfield, LH and Spring, Michael and Grady, Jonathan and Sun, W and Marsh, W and Antoni, M and Dew, MA and Helgeson, V and Schulz, Richard and Tsung, A (2016) Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting. Cancer, 122 (8). 1270 - 1282. ISSN 0008-543X

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Background—The aim of the study was to examine the efficacy of a collaborative care intervention to reduce depression, pain and fatigue and improve quality of life. Participants—A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included (1) a website with written and audiovisual self-management strategies, bulletin board, and other resources; (2) visits with a care coordinator during physician appointment every two months; and (3) telephone follow up every two weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, IL-8, Natural Killer (NK) cell numbers, and caregiver stress and depression.

Results—At baseline, 51% of patients reported one or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms, and were randomized to the intervention, reductions in depression (Cohen’s d=0.71), pain (Cohen’s d=0.62), and fatigue (Cohen’s d=0.26) and improvements in quality of life (Cohen’s d =0.99) were observed when compared to the enhanced usual care arm at 6-months. Reductions in IL-6 (phi=0.18), IL-1β (phi=0.35); IL-1α (phi=0.19); IL-8 (phi=15) and increases in NK cell numbers (phi=0.23) were observed when compared to enhanced usual care arm at 6-months. Reductions in caregiver stress (Cohen’s d=0.75) and depression (Cohen’s d=0.37) were observed at 6-months for caregivers whose loved one was randomized to the intervention arm.

Conclusions—Integration of screening and symptom management into cancer care is recommended.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Steel, JL
Geller, DA
Kim, Kevin H
Butterfield, LH
Spring, Michaelspring@pitt.eduspring
Grady, Jonathan
Sun, W
Marsh, W
Antoni, M
Dew, MA
Helgeson, V
Schulz, Richard
Tsung, A
Date: 15 April 2016
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Journal or Publication Title: Cancer
Volume: 122
Number: 8
Page Range: 1270 - 1282
DOI or Unique Handle: 10.1002/cncr.29906.
Institution: University of Pittsburgh
Schools and Programs: School of Computing and Information > Intelligent Systems Program
Refereed: Yes
ISSN: 0008-543X
Article Type: Research Article
Date Deposited: 27 Jul 2016 20:22
Last Modified: 03 Feb 2021 20:43


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