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Lindman A, Handberg C, Olesen G, Duijts S. A multimodal interdisciplinary rehabilitation programme (HAPPY) for patients undergoing allogeneic non-myeloablative haematopoietic stem cell transplantation: A feasibility study. Eur J Oncol Nurs 2023; 65:102339. [PMID: 37327555 DOI: 10.1016/j.ejon.2023.102339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/19/2023] [Accepted: 04/29/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE To evaluate the feasibility of the multimodal interdisciplinary rehabilitation programme HAPPY, targeting patients with haematological malignancy and undergoing allogeneic non-myeloablative haematopoietic stem cell transplantation (NMA-HSCT). METHOD A single arm longitudinal design was applied to test the feasibility of the 6-month HAPPY programme, which consisted of motivational interviewing dialogues, individual supervised physical exercise training, relaxation exercises, nutritional counselling, and home assignments. The feasibility measures included acceptability, fidelity, exposure, practicability, and safety. Descriptive statistics were conducted. RESULTS From November 2018 to January 2020, thirty patients (mean age (SD) 64.1 (6.5)) were enrolled in HAPPY, of whom 18 patients completed the programme. Acceptance was 88%; attrition 40%; fidelity was 80%-100% for all HAPPY elements except phone calls; exposure of HAPPY elements at the hospital reflected individual differences but was acceptable, whereas exposure of HAPPY elements at home was low. Planning of HAPPY for the individual patient was time consuming, and patients were dependent of reminders and incites from the health care professionals. CONCLUSION Most elements of the rehabilitation programme HAPPY were feasible. Yet, HAPPY will benefit from further development and simplifications before an effectiveness study can be conducted, especially regarding improvement of the intervention elements supporting patients at home.
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Affiliation(s)
- Astrid Lindman
- Department of Haematology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark; Department of Public Health, Faculty of Health, Aarhus University, Denmark.
| | - Charlotte Handberg
- Department of Public Health, Faculty of Health, Aarhus University, Denmark; National Rehabilitation Centre for Neuromuscular Diseases, Kongsvang Allé 23, 8000, Aarhus, Denmark.
| | - Gitte Olesen
- Department of Haematology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Saskia Duijts
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands; Amsterdam UMC, Department of Medical Psychology, Amsterdam UMC Location Vrije Universiteit, Amsterdam, the Netherlands; Cancer Center Amsterdam, Cancer Treatment and Quality of Life, Amsterdam, the Netherlands.
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2
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Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
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Neubert S, Schlecht S, Meng K, Rabe A, Jentschke E. Effects of a Video Sequence Based Intervention on Anxiety, Fatigue and Depression in Cancer Patients: Results of a Randomized Controlled Trial. Integr Cancer Ther 2023; 22:15347354231153172. [PMID: 36799503 PMCID: PMC9940180 DOI: 10.1177/15347354231153172] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Cancer patients often suffer from psychological symptoms and need psychological support. Especially during the COVID-19 pandemic, eHealth interventions might be helpful to overcome the obstacles of the pandemic. This study evaluates the effectiveness of a video sequence-based eHealth intervention on anxiety, fatigue, and depression in cancer patients. METHODS Patients (N = 157) with different tumor entities were randomly assigned to the video intervention group (IG) and the waiting control group (CG). Patients in the IG received a video intervention comprising 8 video sequences over 4 weeks. The videos included psychoeducation on distress and psychological symptoms, Acceptance and Commitment Therapy elements, and Yoga and Qigong exercises. Patients' anxiety and fear of progression (primary outcomes) and secondary outcomes were assessed before randomization (T1) and after the end of the intervention for IG or the waiting period for CG (T2) using self-reported questionnaires (GAD-7, PA-F-KF, EORTC QLQ-FA12, PHQ-8). RESULTS Patients of the IG showed no significant improvement in anxiety (GAD-7; P = .75), fear of progression (FoP-Q-SF; P = .29), fatigue (EORTC QLQ-FA12; P = .72), and depression (PHQ-8; P = .95) compared to patients in the waiting CG. However, symptoms of anxiety, fatigue, and depression decreased in both groups. Exploratory subgroup analysis regarding sex, therapy status, therapy goal, and tumor entity showed no effects. Overall, the intervention had a high level of acceptance. CONCLUSIONS The video intervention was ineffective in reducing the psychological burden compared to a waiting CG. The findings support prior observations of the value of therapeutic guidance and promoting self-management for improving patients' psychological burdens. Further studies are required to evaluate the effectiveness of psycho-oncological eHealth delivered through video sequences.
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Affiliation(s)
- Sven Neubert
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Sina Schlecht
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Karin Meng
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Antonia Rabe
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Elisabeth Jentschke
- University of Würzburg, Comprehensive Cancer Center Mainfranken, Würzburg, Germany,Elisabeth Jentschke, University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef Schneider Str 6, Würzburg D-97080, Germany.
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Báez Gutiérrez N, Rodríguez Ramallo H, Fernández González M, Abdel-Kader Martín L. Smartphone Apps for Patients With Hematologic Malignancies: Systematic Review and Evaluation of Content. JMIR Mhealth Uhealth 2022; 10:e35851. [PMID: 36125860 PMCID: PMC9533204 DOI: 10.2196/35851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 06/21/2022] [Accepted: 09/02/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Hematological malignancies (HMs) are a heterogeneous group of cancers representing a significant cause of morbidity and mortality. The chronification of HMs and the increasing use of smartphones may lead patients to seek their current unmet needs through mobile health apps. OBJECTIVE The goal of this review was to identify and assess the quality of smartphone apps aimed at patients diagnosed with HMs. METHODS A systematic search of apps that were aimed at patients diagnosed with HMs, accessed from a Spain IP address, and were available on the iOS (App Store) and Android (Google Play) platforms was conducted in November 2021. The search terms used were "hematology," "blood cancer," "leukemia," "lymphoma," and "myeloma" apps in English, Spanish, or both languages. The identified apps were downloaded and analyzed independently by 2 reviewers. Information about general app characteristics was collected. The Mobile Application Rating Scale (MARS) was used to assess quality. The resulting parameter of the analyses, the mean score of the apps, was compared by Student t test. RESULTS Overall, 18 apps were identified; 7 were available on Android, 5 were available on iOS, and 6 were available on both platforms. All included apps were free; 3 were published in 2021, and among the apps published before 2021, only 6 were updated in 2021. Most (16/18, 89%) of the apps were aimed at patients with leukemia or lymphoma (16). The primary purposes of the apps were to provide general information about the condition (16/18, 89%) and monitor symptoms and clinical parameters (11/18, 61%). Health care professionals contributed to the development of 50% (9/18) of apps; 6 were owned and supported by scientific societies, and 3 were developed with the participation of health care professionals. The mean MARS score for the overall quality of the apps was 3.1 (SD 1.0). The engagement and aesthetics subscales were the lowest rated subscales, with only 44% (8/18) and 67% (12/18), respectively, of the apps obtaining acceptable scores. None of the included apps proved clinical efficacy through clinical trials in patients with HMs. Statistically significant differences were found in the MARS scores between operating systems (+1.0, P=.003) in favor of iOS apps. The participation of health care professionals in the development of the apps did not have a statistically significant impact on the MARS scores. CONCLUSIONS This systematic search and evaluation identified few acceptable quality mobile apps for patients with HMs. Current and future apps for patients with HMs should provide evidence-based valuable information, improve user engagement, incorporate functions according to patient preferences, and generate evidence regarding the efficacy of app use by patients with HMs.
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Liu B, Yabroff KR, Zheng Z, Tamler R, Han X. Internet-Based Health Care Communication Among Cancer Survivors, 2011-2018 National Health Interview Survey. Prev Chronic Dis 2021; 18:E87. [PMID: 34499600 PMCID: PMC8462291 DOI: 10.5888/pcd18.210163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Understanding trends and associated factors in internet-based health care communication (IBHC) among cancer survivors is important for meeting patient needs because their reliance on telehealth is growing. We aimed to examine IBHC use among cancer survivors in the US. Methods We identified adult cancer survivors aged 18 to 64 (n = 8,029) and 65 or older (n = 11,087) from the National Health Interview Survey in 2011–2018. We calculated temporal trends of self-reported IBHC in the previous year (filled a prescription, scheduled a medical appointment, or communicated with a health care provider) and used multivariable logistic models to identify associated factors. Results Approximately 84% of survivors had been diagnosed 2 years or more before the survey. IBHC prevalence increased among cancer survivors aged 18 to 64, from 19.3% to 40.2%, and among those aged 65 or older, from 11.4% to 22.6%, from 2011 to 2018 (P for trend <.001). Among both age groups, lower educational attainment, lack of usual source of care, and current smoking were associated with less IBHC, whereas residing in the South or West, having 1 or more chronic conditions, and drinking any alcohol were associated with higher IBHC (all P < .05). Factors associated with less IBHC also included being non-Hispanic Black or Hispanic, lacking private insurance, and being 11 or more years postdiagnosis among survivors aged 18 to 64; among survivors aged 65 or older, factors were being an older age, not married, and non-US born (all P < .05). Conclusion IBHC among cancer survivors is common and increasing, with differences across sociodemographic and behavioral characteristics. As health care delivery continues adopting IBHC and other advanced telehealth techniques, disparities need to be addressed to ensure equitable access to care for all cancer survivors.
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Affiliation(s)
- Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Pl, Box 1077, New York, NY 10029.
| | - K Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Zhiyuan Zheng
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Ronald Tamler
- Department of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, 3380 Chastain Meadows Pkwy NW, Suite 200, Kennesaw, GA 30144.
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Micaux C, Wiklander M, Eriksson LE, Wettergren L, Lampic C. Efficacy of Fex-Can Fertility, a web-based psychoeducational intervention for young adults with fertility-related distress following cancer: a randomized controlled trial. (Preprint). JMIR Cancer 2021; 8:e33239. [PMID: 35348459 PMCID: PMC9006131 DOI: 10.2196/33239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/18/2021] [Accepted: 02/07/2022] [Indexed: 01/02/2023] Open
Affiliation(s)
- Claire Micaux
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Stockholm, Sweden
| | - Maria Wiklander
- Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Stockholm, Sweden
| | - Lars E Eriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska institutet, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Infectious Diseases, Karolinska University Hospital, Huddinge, Sweden
- School of Health Sciences, City, University of London, London, United Kingdom
| | - Lena Wettergren
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Claudia Lampic
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- Department of Psychology, Umeå University, Umeå, Sweden
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Bouleftour W, Daguenet E, Tinquaut F, Magne N. Impact of COVID-19 Outbreak through Telemedicine Implementation on Data Reporting During Oncology Clinical Trials. Cancer Invest 2020; 39:15-20. [PMID: 33258396 DOI: 10.1080/07357907.2020.1858311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Coronavirus disease outbreak has affected all aspect of clinical care including cancer clinical trials. To minimize exposure of frail cancer patients, an implementation of telemedicine was retained. The impact of this implementation on primary and secondary endpoints criteria of ongoing clinical trials was analyzed. Out of 128 oncology clinical trials, 25 (19%) had an implementation of teleconsultation. Poor data reporting induced mainly a bias on qualitative and descriptive primary endpoints than those assessing efficacy (80% vs 20%; p < 0.001). The integration of telemedicine and E-technologies in the medical practices and clinical trials must be designed and validated.
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Affiliation(s)
- Wafa Bouleftour
- Clinical Research Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France.,Medical Oncology Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Elisabeth Daguenet
- Clinical Research Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France.,Radiotherapy Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Fabien Tinquaut
- Clinical Research Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
| | - Nicolas Magne
- Clinical Research Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France.,Radiotherapy Department, Lucien Neuwirth Cancer Institute, Saint Priest en Jarez, France
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