Heidi S Donovan1,2, Susan M Sereika1, Lari B Wenzel3, Robert P Edwards2, Judith E Knapp1, Susan H Hughes4, Mary C Roberge1, Teresa H Thomas1, Sara Jo Klein1, Michael B Spring5, Susan Nolte6, Lisa M Landrum7, A Catherine Casey8, David G Mutch9, Robert L DeBernardo10, Carolyn Y Muller11, Stephanie A Sullivan12, Sandra E Ward4. 1. University of Pittsburgh School of Nursing, Pittsburgh, PA. 2. Magee Womens Hospital of UPMC Hillman Cancer Center, Pittsburgh, PA. 3. Medicine and Public Health, University of California, Irvine, CA. 4. University of Wisconsin, Madison, WI. 5. University of Pittsburgh School of Computing and Information, Pittsburgh, PA. 6. Abington Memorial Hospital, Gynecologic Oncology Institute, Abington, PA. 7. Stephenson Cancer Center Gynecologic Cancers Clinic, University of Oklahoma Health Sciences Center, Oklahoma City, OK. 8. Minnesota Oncology, Edina, MN. 9. Washington University School of Medicine, Siteman Cancer Center, St Louis, MO. 10. Obstetrics and Gynecology, Cleveland Clinic, Cleveland, OH. 11. Gynecologic Oncology, UNM School of Medicine, University of New Mexico Albuquerque, NM. 12. Gynecology Oncology, VCU Medical Center North Hospital, Richmond, VA.
Abstract
PURPOSE: GOG-259 was a 3-arm randomized controlled trial of two web-based symptom management interventions for patients with recurrent ovarian cancer. Primary aims were to compare the efficacy of the nurse-guided (Nurse-WRITE) and self-directed (SD-WRITE) interventions to Enhanced Usual Care (EUC) in improving symptoms (burden and controllability) and quality of life (QOL). METHODS: Patients with recurrent or persistent ovarian, fallopian, or primary peritoneal cancer with 3+ symptoms were eligible for the study. Participants completed baseline (BL) surveys (symptom burden and controllability and QOL) before random assignment. WRITE interventions lasted 8 weeks to develop symptom management plans for three target symptoms. All women received EUC: monthly online symptom assessment with provider reports; online resources; and every 2-week e-mails. Outcomes were evaluated at 8 and 12 weeks after BL. Repeated-measures modeling with linear contrasts evaluated group by time effects on symptom burden, controllability, and QOL, controlling for key covariates. RESULTS: Participants (N = 497) reported mean age of 59.3 ± 9.2 years. At BL, 84% were receiving chemotherapy and reported a mean of 14.2 ± 4.9 concurrent symptoms, most commonly fatigue, constipation, and peripheral neuropathy. Symptom burden and QOL improved significantly over time (P < .001) for all three groups. A group by time interaction (P < .001) for symptom controllability was noted whereby both WRITE intervention groups had similar improvements from BL to 8 and 12 weeks, whereas EUC did not improve over time. CONCLUSION: Both WRITE Intervention groups showed significantly greater improvements in symptom controllability from BL to 8 and BL to 12 weeks compared with EUC. There were no significant differences between Nurse-WRITE and SD-WRITE. SD-WRITE has potential as a scalable intervention for a future implementation study.
PURPOSE: GOG-259 was a 3-arm randomized controlled trial of two web-based symptom management interventions for patients with recurrent ovarian cancer. Primary aims were to compare the efficacy of the nurse-guided (Nurse-WRITE) and self-directed (SD-WRITE) interventions to Enhanced Usual Care (EUC) in improving symptoms (burden and controllability) and quality of life (QOL). METHODS: Patients with recurrent or persistent ovarian, fallopian, or primary peritoneal cancer with 3+ symptoms were eligible for the study. Participants completed baseline (BL) surveys (symptom burden and controllability and QOL) before random assignment. WRITE interventions lasted 8 weeks to develop symptom management plans for three target symptoms. All women received EUC: monthly online symptom assessment with provider reports; online resources; and every 2-week e-mails. Outcomes were evaluated at 8 and 12 weeks after BL. Repeated-measures modeling with linear contrasts evaluated group by time effects on symptom burden, controllability, and QOL, controlling for key covariates. RESULTS: Participants (N = 497) reported mean age of 59.3 ± 9.2 years. At BL, 84% were receiving chemotherapy and reported a mean of 14.2 ± 4.9 concurrent symptoms, most commonly fatigue, constipation, and peripheral neuropathy. Symptom burden and QOL improved significantly over time (P < .001) for all three groups. A group by time interaction (P < .001) for symptom controllability was noted whereby both WRITE intervention groups had similar improvements from BL to 8 and 12 weeks, whereas EUC did not improve over time. CONCLUSION: Both WRITE Intervention groups showed significantly greater improvements in symptom controllability from BL to 8 and BL to 12 weeks compared with EUC. There were no significant differences between Nurse-WRITE and SD-WRITE. SD-WRITE has potential as a scalable intervention for a future implementation study.
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Authors: Erin L Merz; Scott C Roesch; Vanessa L Malcarne; Frank J Penedo; Maria M Llabre; Orit B Weitzman; Elena L Navas-Nacher; Krista M Perreira; Franklyn Gonzalez; Liliana A Ponguta; Timothy P Johnson; Linda C Gallo Journal: Psychol Assess Date: 2013-12-09
Authors: Robert L Coleman; Gini F Fleming; Mark F Brady; Elizabeth M Swisher; Karina D Steffensen; Michael Friedlander; Aikou Okamoto; Kathleen N Moore; Noa Efrat Ben-Baruch; Theresa L Werner; Noelle G Cloven; Ana Oaknin; Paul A DiSilvestro; Mark A Morgan; Joo-Hyun Nam; Charles A Leath; Shibani Nicum; Andrea R Hagemann; Ramey D Littell; David Cella; Sally Baron-Hay; Jesus Garcia-Donas; Mika Mizuno; Katherine Bell-McGuinn; Danielle M Sullivan; Bruce A Bach; Sudipta Bhattacharya; Christine K Ratajczak; Peter J Ansell; Minh H Dinh; Carol Aghajanian; Michael A Bookman Journal: N Engl J Med Date: 2019-09-28 Impact factor: 91.245