Davis Kimberly, Yount Susan, Del Ciello Katie, Whalen Margaret, Khan Shaheen, Bass Mike, Du Hongyan, Eton David, Masters Gregory, Hensing Thomas, Cella David
Georgetown University Medical Center, Department of Oncology, Lombardi Comprehensive Cancer Center, Washington, DC 20007, USA.
J Support Oncol. 2007 Sep;5(8):381-7.
Treatment for advanced lung cancer is not curative; therefore, the primary goals of its care are to maximize symptom management and minimize treatment toxicity. Increasingly, patient-reported symptoms and health-related quality of life (HRQL) outcomes have been accepted as important endpoints; several validated measures have gained wide acceptance in research, but their use in practice has been limited. Computer technology increasingly is used to reduce patient and administrative burden in conducting assessments to produce a real-time presentation of symptom and HRQL data. This paper describes a technology-based monitoring system developed for patients with advanced lung cancer who were starting chemotherapy. Among the 90 participants, compliance with the weekly symptom survey was 92%. Patient acceptability of the system was high, as evidenced by 30 patients who elected to complete an additional monitoring interval beyond the 12-week study period. Of patients who reported discussing their responses with a provider (95%), a majority (69%) stated that the questionnaire helped them to focus on issues to be discussed with their physicians. The system also was favorably reviewed by physicians, who indicated that the report helped them to compare patients' responses over time. Next steps will include a randomized trial to test the system's efficacy in improving symptom management.
晚期肺癌的治疗无法治愈;因此,其护理的主要目标是最大限度地控制症状并将治疗毒性降至最低。患者报告的症状和健康相关生活质量(HRQL)结果越来越被视为重要的终点指标;几种经过验证的测量方法在研究中已得到广泛认可,但在实际应用中却受到限制。计算机技术越来越多地用于减轻患者和行政负担,以便在进行评估时实时呈现症状和HRQL数据。本文描述了一种为开始化疗的晚期肺癌患者开发的基于技术的监测系统。在90名参与者中,每周症状调查的依从率为92%。该系统的患者接受度很高,有30名患者选择在12周的研究期之外完成额外的监测期。在报告与医护人员讨论过自己回答的患者中(95%),大多数(69%)表示问卷帮助他们关注了与医生讨论的问题。医生对该系统也给予了好评,他们表示报告有助于他们比较患者不同时间的回答。下一步将包括一项随机试验,以测试该系统在改善症状管理方面的效果。