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Randomized Controlled Trial
. 2007 Sep;34(3):253-64.
doi: 10.1016/j.jpainsymman.2006.11.018. Epub 2007 Jul 9.

Symptom management for cancer patients: a trial comparing two multimodal interventions

Alla Sikorskii  1 , Charles W Given, Barbara Given, Sangchoon Jeon, Veronica Decker, David Decker, Victoria Champion, Ruth McCorkle
Affiliations
Randomized Controlled Trial

Symptom management for cancer patients: a trial comparing two multimodal interventions

Alla Sikorskii et al. J Pain Symptom Manage. 2007 Sep.

Abstract

The results of a randomized controlled trial that tested the effects of eight-week, six-contact multidimensional interactive interventions for symptom management are presented. Four hundred and thirty-five cancer patients with solid tumors undergoing chemotherapy were randomized to receive either nurse-assisted symptom management (NASM) or automated telephone symptom management (ATSM). A prior trial established the effectiveness of NASM compared with conventional care. Seventeen symptoms commonly experienced by patients undergoing chemotherapy were rated on a scale from 0 to 10 and were evaluated at baseline, at each of the six intervention contacts, and postintervention observation at 10 weeks. Both groups achieved significant reduction in symptom severity over baseline, and there was no difference between groups on symptom severity at 10 weeks. Randomization accounted for possible reductions in severity due to response shifts. Severity of symptoms reported by patients at each of the six intervention contacts was measured using a Rasch model. Symptom pattern was different for lung and non-lung cancer patients, and they were analyzed separately. Longitudinal analyses revealed that lung cancer patients with greater symptom severity withdrew from later intervention contacts of the ATSM. The results suggest that both NASM and ATSM achieved a clinically significant reduction in symptom severity. The NASM may be more effective than ATSM in retaining lung cancer patients in the intervention. Further testing of ATSM supplemented by NASM for patients with severe symptoms is warranted.

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Figures

Figure 1
Figure 1
Flowchart of the study (1a indicates a patient who never received any intervention in ATSM group and had interview at baseline and 20 weeks).
Figure 2
Figure 2
Strategies to address insomnia.
Figure 2
Figure 2
Strategies to address insomnia.
Figure 3
Figure 3
Prevalence above threshold for selected symptoms across contacts.
Figure 3
Figure 3
Prevalence above threshold for selected symptoms across contacts.
Figure 4
Figure 4
Trend in unadjusted mean Rasch severity scores among lung cancer patients.
Figure 5
Figure 5
Trend in unadjusted mean Rasch severity scores among non lung cancer patients.
See this image and copyright information in PMC

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