Public Health Sciences, Penn State College of Medicine, 500 University Drive, Hershey, PA, 17033, USA.
University of Alabama at Birmingham, Birmingham, AL, USA.
J Cancer Surviv. 2021 Jun;15(3):410-413. doi: 10.1007/s11764-021-01021-x. Epub 2021 Mar 11.
Although metastatic breast cancer (MBC) survival is improving, symptoms remain a significant burden. Returning to a cancer center for symptom management can be challenging. Technology-enabled supportive care platforms are worth exploration.
Seventeen patients with MBC were randomized to immediate or delayed start for a 3-month intervention that included daily tablet-based guideline-concordant self-care for pain, distress, fatigue, and sleep disturbance, as well as weekly calls with a patient navigator. The primary outcome was patient acceptability. We also assessed feasibility, patient satisfaction, and cost and compared between group differences for symptoms. RM-ANOVA examined between group differences over time. Hedges' d effect sizes quantified magnitude of differences in change between immediate and delayed start.
Sixty-eight percent of patients approached accepted the tablet-based intervention. Patients interacted with the tablet 48% of possible days. Patient satisfaction ranged from 83 for walking to 49% for the psychological interventions. The cost of delivering Nurse AMIE for 3 months was $570.23. Small nonsignificant improvements were found for fatigue (d=0.24). Nonsignificant, but potentially clinically meaningful, moderate reductions were found for sleep (d=0.65) and distress (d=0.74).
A tablet-based supportive care platform that offers guideline-concordant self-care for pain, fatigue, sleep, and distress was observed to be highly acceptable and feasible for patients with metastatic breast cancer. Patient satisfaction scores and initial evaluation of efficacy are promising, and the platform warrants further investigation.
Technology-based self-care is a promising option to address symptoms in patients with metastatic breast cancer.
尽管转移性乳腺癌（MBC）的生存率有所提高，但症状仍是一个重大负担。返回癌症中心进行症状管理可能具有挑战性。技术支持的支持性护理平台值得探索。
17 名 MBC 患者被随机分为立即开始或延迟开始接受为期 3 个月的干预，该干预包括基于日常片剂的指南一致的自我护理，用于治疗疼痛、困扰、疲劳和睡眠障碍，以及每周与患者导航员通话一次。主要结果是患者的可接受性。我们还评估了可行性、患者满意度和成本，并比较了组间症状差异。RM-ANOVA 检验了组间随时间的差异。Hedges' d 效应大小量化了即时和延迟开始之间变化差异的幅度。
68%的患者接受了基于片剂的干预措施。患者每天与片剂交互的比例为 48%。患者满意度从步行的 83%到心理干预的 49%不等。提供 3 个月的 Nurse AMIE 的成本为 570.23 美元。疲劳（d=0.24）有较小的、无统计学意义的改善。睡眠（d=0.65）和困扰（d=0.74）有较小的、但可能有临床意义的中度降低。
一种提供疼痛、疲劳、睡眠和困扰的指南一致的自我护理的基于片剂的支持性护理平台，被观察到对转移性乳腺癌患者高度可接受和可行。患者满意度评分和初步疗效评估是有希望的，该平台值得进一步研究。
基于技术的自我护理是一种有前途的选择，可以解决转移性乳腺癌患者的症状。
