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采用电子健康解决方案提供的居家乳腺肿瘤护理(ABODE)研究方案:一项随机对照试验。

At-home Breast Oncology care Delivered with EHealth solutions (ABODE) study protocol: a randomised controlled trial.

作者信息

Mac Amanda, Kalia Mohini, Reel Emma, Amir Eitan, Isenberg Adina, Kim Raymond H, Kennedy Erin, Koch C Anne, Li Madeline, McCready David, Metcalfe Kelly, Okrainec Allan, Papadakos Janet, Rotstein Sarah, Rodin Gary, Xu Wei, Zhong Toni, Cil Tulin D

机构信息

Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Division of General Surgery, Department of Surgery, University Health Network, Toronto, Ontario, Canada.

出版信息

BMJ Open. 2025 May 8;15(5):e091579. doi: 10.1136/bmjopen-2024-091579.

Abstract

INTRODUCTION

The COVID-19 pandemic disrupted healthcare delivery for patients with breast cancer. eHealth solutions enable remote care and may improve patient activation, which is defined as having the knowledge, skills and confidence to manage one's health. Thus, we developed the Breast Cancer Treatment Application (app) for patients and practitioners to use throughout the cancer care continuum. The app facilitates virtual assistance, delivers educational resources, collects patient-reported outcome measures and provides individualised support via volunteer e-coaches. Among newly diagnosed patients with breast cancer, we will compare changes in patient activation, other patient-reported outcomes and health service outcomes over 1 year between those using the app and Fitbit, and those receiving standard care and Fitbit only.

METHODS AND ANALYSIS

This randomised controlled trial will include 200 patients with breast cancer seen at a tertiary care cancer centre in Ontario, Canada. The intervention group (n=100) will use the app in addition to standard care and Fitbit for 13 months following diagnosis. The control group (n=100) will receive standard care and Fitbit only. Patients will complete questionnaires at enrolment, 6 and 12 months post-diagnosis to measure patient activation (Patient Activation Measure-13 score), distress, anxiety, quality of life and experiences with their care and information received. All patients will also receive Fitbits to measure activity and heart rate. We will also measure wait times and number of visits to ambulatory care services to understand the impact of the app on the use of in-person services.

ETHICS AND DISSEMINATION

Ethics approval was obtained on 6 January 2023. Protocol version 2.0 was approved on 6 January 2023. The trial is registered with ClinicalTrials.gov. Study findings will be disseminated via publication in a peer-reviewed journal and shared with participants, patient programmes and cancer awareness groups. The app has also been approved as a secure communication method at our trial institution, thus we are well-positioned to support future integration of the app into standard care through collaboration with our hospital network.

TRIAL REGISTRATION NUMBER

NCT05989477.

摘要

引言

新冠疫情扰乱了乳腺癌患者的医疗服务。电子健康解决方案可实现远程护理,并可能提高患者的自我管理能力,即具备管理自身健康的知识、技能和信心。因此,我们为患者和医护人员开发了乳腺癌治疗应用程序(应用),以便在整个癌症护理过程中使用。该应用程序提供虚拟协助、提供教育资源、收集患者报告的结局指标,并通过志愿者电子教练提供个性化支持。在新诊断的乳腺癌患者中,我们将比较使用该应用程序和Fitbit的患者与仅接受标准护理和Fitbit的患者在1年内患者自我管理能力、其他患者报告的结局以及医疗服务结局的变化。

方法与分析

这项随机对照试验将纳入200名在加拿大安大略省一家三级癌症护理中心就诊的乳腺癌患者。干预组(n = 100)在确诊后除接受标准护理和使用Fitbit外,还将使用该应用程序13个月。对照组(n = 100)将仅接受标准护理和Fitbit。患者将在入组时、确诊后6个月和12个月完成问卷调查,以测量患者的自我管理能力(患者自我管理能力量表-13得分)、痛苦、焦虑、生活质量以及他们对护理和所获信息的体验。所有患者还将佩戴Fitbit来测量活动量和心率。我们还将测量等待时间和门诊护理服务的就诊次数,以了解该应用程序对面对面服务使用的影响。

伦理与传播

2023年1月6日获得伦理批准。2023年1月6日批准了方案版本2.0。该试验已在ClinicalTrials.gov上注册。研究结果将通过在同行评审期刊上发表进行传播,并与参与者、患者项目和癌症宣传团体分享。该应用程序也已在我们的试验机构被批准为一种安全的沟通方式,因此我们有能力通过与医院网络合作,支持未来将该应用程序整合到标准护理中。

试验注册号

NCT05989477。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/04a5/12067776/d1e9e3d2d8a2/bmjopen-15-5-g001.jpg

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