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
Abstract
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
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Status: |
Published |
Creators/Authors: |
Creators | Email | Pitt Username | ORCID |
---|
Steel, JL | | | | Geller, DA | | | | Kim, Kevin H | | | | Butterfield, LH | | | | Spring, Michael | spring@pitt.edu | spring | | Grady, Jonathan | | | | Sun, W | | | | Marsh, W | | | | Antoni, M | | | | Dew, MA | | | | Helgeson, V | | | | Schulz, Richard | | | | Tsung, A | | | |
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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 |
URI: |
http://d-scholarship.pitt.edu/id/eprint/28452 |
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