BACKGROUND: In this study, the authors examined the effectiveness of an online support system (Comprehensive Health Enhancement Support System [CHESS]) versus the Internet in relieving physical symptom distress in patients with non-small cell lung cancer (NSCLC).

METHODS: In total, 285 informal caregiver-patient dyads were assigned randomly to receive, for up to 25 months, standard care plus training on and access to either use of the Internet and a list of Internet sites about lung cancer (the Internet arm) or CHESS (the CHESS arm). Caregivers agreed to use CHESS or the Internet and to complete bimonthly surveys; for patients, these tasks were optional. The primary endpoint-patient symptom distress-was measured by caregiver reports using a modified Edmonton Symptom Assessment Scale.

RESULTS: Caregivers in the CHESS arm consistently reported lower patient physical symptom distress than caregivers in the Internet arm. Significant differences were observed at 4 months (P = .031; Cohen d = .42) and at 6 months (P = .004; d = .61). Similar but marginally significant effects were observed at 2 months (P = .051; d = .39) and at 8 months (P = .061; d = .43). Exploratory analyses indicated that survival curves did not differ significantly between the arms (log-rank P = .172), although a survival difference in an exploratory subgroup analysis suggested an avenue for further study.

CONCLUSIONS: The current results indicated that an online support system may reduce patient symptom distress. The effect on survival bears further investigation.

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Published in Cancer, v. 119, issue 9, p. 1744-1751.

Copyright © 2013 American Cancer Society

This is the accepted version of the following article: Gustafson, D. H., DuBenske, L. L., Namkoong, K., Hawkins, R., Chih, M.-Y., Atwood, A. K., Johnson, R., Bhattacharya, A., Carmack, C. L., Traynor, A. M., Campbell, T. C., Buss, M. K., Govindan, R., Schiller, J. H. and Cleary, J. F. (2013), An eHealth system supporting palliative care for patients with non–small cell lung cancer. Cancer, 119: 1744-1751, which has been published in final form at https://doi.org/10.1002/cncr.27939. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

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Funding Information 

This study was supported by a grant from the National Cancer Institute (P50 CA095817).