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Supportive Care / Symptom Management (Prevention of Cancer Morbidity)

Projects and Investigators

Patient-Centered Communication During Chemotherapy

Program Description:

Pain, depression, and fatigue are among the most common disease and treatment-related symptoms experienced by cancer patients. Studies have indicated that communication problems between cancer patients and clinicians are a major barrier to the effective management of these symptoms. This project is designed to address this important problem through the development and evaluation of a PDA-based patient communication intervention for breast cancer patients undergoing chemotherapy treatment. The intervention will be comprised of two integrated components: symptom monitoring and tailored patient communication training. Patients will be asked to complete fatigue, depression, and pain inventories on a PDA at the beginning of chemotherapy and once per week through the completion of treatment. On the day prior to an appointment for chemotherapy treatment, a summary of fatigue, depression, and pain scores will be integrated with a tailored patient communication skills training program and displayed on the PDA for patient viewing. Patients will be taught, through role modeling, how to effectively communicate the types of symptoms they have experienced between treatments. They will also be encouraged to bring the PDA with their symptom summaries to each chemotherapy visit and to share this information with their health care provider. Year one of the project will primarily be devoted to the development and usability testing of the intervention. A feasibility trial will be conducted during the second year. Fifty patients with breast cancer will be recruited into the trial at the start of their chemotherapy treatment. A repeated measures design will be used to assess the effects of the intervention on symptoms of fatigue, depression, and pain over the course of treatment. At the end of treatment, focus groups will be conducted with study participants to assess their responses to the intervention and their perceptions of the system's value to both themselves and future cancer patients. In addition, the feasibility of the project, defined as the proportion of patients recruited into the study and the proportion of patient adherence to instructed use of the system, will be analyzed. Specific aims of the project include: 1) Develop the patient-centered communication intervention; 2) Conduct usability testing to ensure the successful completion of the intervention; 3) Examine study feasibility and patient reactions to the intervention; and 4) Evaluate intervention effects on pain, depression, and fatigue symptoms over time.