Cancer, Leukemia, Lymphoma, Stem Cell Transplantation
Conditions
Keywords
Symptom management, Cancer, Patient-centered care
Brief summary
Patient-provider shared decision making and the inclusion of patients' illness experiences and preferences in patient care are prioritized areas in health care. CHOICE is a computer-based support system for patient-centered symptom management of cancer patients developed for this purpose. In this randomized clinical trial at Rikshospitalet- Radiumhospitalet HF 145 adult stem-cell transplantation and newly diagnosed lymphoma and leukemia patients used CHOICE for assessments of their symptoms, problems and priorities for care at in-and outpatient visits during treatment and rehabilitation. In the experimental group this information was shared with physicians an nurses for subsequent care planning, but not in the control group. This study tested effects of CHOICE on symptom- related patient care and outcomes of symptom relief, patients' needs for care over time and patient satisfaction;(2) analyzed how patients' symptoms, needs for care varied during illness/treatment stages; and (3) evaluated CHOICE' ease of use and user satisfaction. Controlling for gender, age, diagnosis, and type/stage of treatment, education, depression, health related quality of life, and social support, repeated measurement models were used to test differences and variations in outcome variables within and between groups and over time.
Detailed description
as above
Interventions
BEHAVIORALTailored assessments provided to physicians and nurses (CHOICE, the Computer-assisted Interactive Tailored Patient Assessment Tool (ITPA))
Both groups used CHOICE, the Computer-assisted Interactive Tailored Patient Assessment Tool (ITPA)for symptom assessments at in- and outpatient visits during and up-to nine months after treatment. In the intervention group physicians and nurses had assessment summaries available for care planning, displaying patients' symptoms, problems and concerns in rank-order of their needs for care. In the control group assessments were not available to care providers at any time.
Sponsors
The Research Council of Norway
Oslo University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Starting treatment for a newly diagnosed acute myelogenous leukemia (AML), lymphatic leukemia (ALL), Hodgkin or non-Hodgkin lymphoma, or * starting treatment for a recurrence of the disease; * starting treatment with allogenous or autologous Stem Cell Transplantation (SCT). * above 18 years of age.
Exclusion criteria
* having received radiation on the brain
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Patients' prioritized needs for care over time | Repeated episodes of care |
| Physicians' and nurses' symptom-related chart entries in patients' records | In-patient episodes of care |
| Symptom distress over time | Repeated episodes of care |
Secondary
| Measure | Time frame |
|---|---|
| Patient satisfaction | End of study |
| Care providers' satisfaction | End of study |
| Preferences for participation in decision making- and changes over time | Baseline, and at completion of treatment |
Outcome results
None listed