Nursing intervention to enhance outpatient chemotherapy symptom management: Patient‐reported outcomes of a randomized controlled trial

• Published in: Cancer 2015-11, Vol.121 (21), p.3905-3913
• Main Authors: Traeger, Lara, McDonnell, Theresa M., McCarty, Caitlin E., Greer, Joseph A., El‐Jawahri, Areej, Temel, Jennifer S.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Ambulatory Care; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Breast Neoplasms - drug therapy; chemotherapy; Colorectal Neoplasms - drug therapy; Depression - epidemiology; Disease Management; Drug-Related Side Effects and Adverse Reactions - prevention & control; Drug-Related Side Effects and Adverse Reactions - psychology; Drug-Related Side Effects and Adverse Reactions - therapy; Female; health services intervention; Humans; Incidence; Lung Neoplasms - drug therapy; Male; Middle Aged; Neoplasms - drug therapy; Neoplasms - psychology; nursing; oncology; Oncology Nursing; Outcome Assessment (Health Care); Patient Satisfaction; patient‐reported outcomes; Self Report; Surveys and Questionnaires
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.29585

BACKGROUND The authors conducted a randomized controlled trial to evaluate a nurse practitioner (NP)‐delivered symptom management intervention for patients initiating chemotherapy for nonmetastatic cancer. The aim was to reduce patient‐reported symptom burden by facilitating patient‐NP collaboration and the early management of symptoms. METHODS At the time of the first chemotherapy visit, adult participants with nonmetastatic breast, colorectal, or lung cancer (120 participants) completed self‐report measures and were then randomly assigned to standard care plus the intervention or standard care alone. Intervention participants received proactive telephone calls from their oncology team NP during the week after each of the first 2 chemotherapy administration visits. Measures were repeated at the second and third chemotherapy visits. Group differences were analyzed with regard to patient‐reported symptoms (Memorial Symptom Assessment Scale‐Short Form items), satisfaction with care (Family Caregiver Satisfaction‐patient scale), and the likelihood of depression or anxiety symptoms (Patient Health Questionnaire‐4). RESULTS At the time of the first visit, 50.8% of participants reported ≥1 physical symptom, most commonly lack of energy (35.8%) and drowsiness (30.8%). The number of symptoms (gamma coefficient [γ] = 0.16; P