基于电子患者报告结局的生理和心理症状管理：TD-健康随机临床试验。
Physiological and psychological symptom management based on electronic patient-reported outcomes: the TD-WELLBEING randomized clinical trial.
作者信息
Jing Pengyu, Liang Ying, Tan Zhijun, Yan Xiaolong, Lei Jie, Ni Yunfeng, Zhu Ximing, Qiu Chun, Wang Jian, Ge Peng, Zhang Yong, Wang Lv, Zhao Nan, Zhang Yong, Wang Juan, Wang Yan, Zheng Chunlong, Shao Qiongjie, Zhang Haiyue, Yang Zhe, Li Haichao, Fan Jiangjiang, Liu Siming, Kyriacou Kyriacos, Shang Lei, Gu Zhongping
机构信息
Department of Thoracic Surgery, The Second Affiliated Hospital of the Fourth Military Medical University, Xi'an, China.
Department of Health Statistics, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, the Fourth Military Medical University, Xi'an, China.
出版信息
Br J Cancer. 2025 Aug 7. doi: 10.1038/s41416-025-03110-5.
BACKGROUND
One-third of all lung cancer cases globally are reported in China. This study evaluated the symptom management efficacy of an electronic patient-reported outcomes (ePRO)-based intervention for postoperative symptoms like pain and psychological distress after lung cancer surgery.
METHODS
We included lung cancer surgery patients (April 2022-October 2023; age, 18-75 years) with ECOG scores of 0-2 and expected survival of >6 months and randomized them into control and intervention groups. The latter completed MDASI-LC and QLQ-C30 questionnaires, wherein high symptom scores prompted treatment recommendations; the former received routine care. Changes in symptom scores, daily function, and quality of life were evaluated over 12 weeks and 1 year through surveys and interviews for ePRO-based symptom management efficacy assessments.
RESULTS
Herein, 355 participants comprised intervention (n = 182) and control groups (n = 173). At 12 weeks, the former had significantly lower symptoms threshold [0 (0-1) vs. 1 (0-3)], lower symptom scores [adjusted mean difference, -0.527 (95% CI: -0.788 to -0.266)], and higher QOL scores (emotional function: 2.908; 95% CI: 0.600-5.216, P = 0.014; global health: 6.775; 95% CI: 3.967-9.583).
CONCLUSIONS
ePRO-based collaborative management effectively lessened postoperative burden and improved QOL beyond 6 months.
背景
全球三分之一的肺癌病例在中国被报道。本研究评估了基于电子患者报告结局（ePRO）的干预措施对肺癌手术后疼痛和心理困扰等术后症状的管理效果。
方法
我们纳入了2022年4月至2023年10月期间年龄在18至75岁、ECOG评分为0至2且预期生存期大于6个月的肺癌手术患者，并将他们随机分为对照组和干预组。干预组完成MDASI-LC和QLQ-C30问卷，其中高症状评分会提示治疗建议；对照组接受常规护理。通过调查和访谈评估12周和1年期间症状评分、日常功能和生活质量的变化，以评估基于ePRO的症状管理效果。
结果
本研究中，355名参与者组成了干预组（n = 182）和对照组（n = 173）。在12周时，干预组的症状阈值显著更低[0（0 - 1）对1（0 - 3）]，症状评分更低[调整后平均差异，-0.527（95%CI：-0.788至-0.266）]，生活质量评分更高（情绪功能：2.908；95%CI：0.600 - 5.216，P = 0.014；总体健康：6.775；95%CI：3.967 - 9.583）。
结论
基于ePRO的协作管理有效减轻了术后负担，并在6个月后改善了生活质量。
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