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Randomized Controlled Trial
. 2025 Feb 15;33(3):196.
doi: 10.1007/s00520-025-09230-1.

Effects of nurse-led symptom management in chronic myeloid malignancies: a randomized trial

Maja Pedersen  1   2 , Maria Torp Larsen  3 , Brian Thomas Kornblit  3 , Emma Ove Dahl  4 , Kirsten Lomborg  5   6 , Anders Tolver  4 , Mary Jarden  3   5
Affiliations
Randomized Controlled Trial

Effects of nurse-led symptom management in chronic myeloid malignancies: a randomized trial

Maja Pedersen et al. Support Care Cancer. .

Abstract

Purpose: Chronic hematological malignancies progress slowly, potentially manifesting symptoms spanning months to years. HM-PRO is developed as a comprehensive clinical tool for assessing symptoms in hematology. The aim was to investigate the effect of a nurse-led systematic approach to symptom identification and management using HM-PRO in outpatient care in patients with chronic hematological malignancies.

Methods: This is a randomized trial including 94 patients to investigate an intervention comprising (1) HM-PRO data collection, (2) HM-PRO assessment guided by an algorithm, and (3) nurse-led tailored symptom management. The control arm received standard follow-up care. The primary outcome was change in QoL. Secondary outcomes were change in prevalence of physical and psychological symptoms.

Results: A statistically significant difference in QoL change scores over time favored the intervention (diff. 10.3; p = .04). For secondary endpoints, a significant between group difference in change over time for severity scores was observed in fatigue (diff. - 13.6; p = .003), overall symptom burden (diff. - 0.7 points; p = .029), emotional functioning (diff. 10.0; p < .0001), and anxiety (diff. - 2.5; p = .001).

Conclusion: A 12-month nurse-led symptom management intervention within hematology significantly improved QoL, emotional functioning, fatigue, anxiety, and overall symptom burden over time. This is the first randomized trial investigating nurse-led clinical application of the HM-PRO questionnaire providing knowledge on the efficacy of systematic symptom management in clinical practice. This study highlights both the pivotal role of nurses and multidisciplinary support and the inherent value of tailored symptom management.

Trial registration: Clinical trial registration number: NCT04757545 (02/12/2021).

Keywords: HM-PRO; Hematological malignancies; Nurse-led; Patient-reported outcomes; Quality of life; Symptom management.

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Conflict of interest statement

Declarations. Ethics approval: This study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was registered with the Regional Ethics Committee for the Capital Region of Denmark (20070444) and received approval by the Danish Protection Agency (P-2020–1085). Consent to participate: Informed consent was obtained from all participants included in the study. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The symptom management intervention. Abbreviations: HM-PRO, Hematological Malignancy Patient-Reported Outcome
Fig. 2
Fig. 2
Flowchart
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