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An eHealth system supporting palliative care for patients with non–small cell lung cancer
Author(s) -
Gustafson David H.,
DuBenske Lori L.,
Namkoong Kang,
Hawkins Robert,
Chih MingYuan,
Atwood Amy K.,
Johnson Roberta,
Bhattacharya Abhik,
Carmack Cindy L.,
Traynor Anne M.,
Campbell Toby C.,
Buss Mary K.,
Govindan Ramaswamy,
Schiller Joan H.,
Cleary James F.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.27939
Subject(s) - medicine , distress , lung cancer , clinical endpoint , the internet , palliative care , physical therapy , ehealth , health care , randomized controlled trial , nursing , clinical psychology , world wide web , computer science , economics , economic growth
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. Cancer 2013. © 2013 American Cancer Society.