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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This study was supported by a grant from the National Cancer Institute (P50 CA095817).
Gustafson, David H.; DuBenske, Lori L.; Namkoong, Kang; Hawkins, Robert; Chih, Ming-Yuan; Atwood, Amy K.; Johnson, Roberta; Bhattacharya, Abhik; Carmack, Cindy L.; Traynor, Anne M.; Campbell, Toby C.; Buss, Mary K.; Govindan, Ramaswamy; Schiller, Joan H.; and Cleary, James F., "An eHealth System Supporting Palliative Care for Patients with Non-Small Cell Lung Cancer: A Randomized Trial" (2013). Community & Leadership Development Faculty Publications. 1.