TY - JOUR
T1 - Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery
T2 - A Multicenter Randomized Controlled Trial
AU - Dai, Wei
AU - Feng, Wenhong
AU - Zhang, Yuanqiang
AU - Wang, Xin Shelley
AU - Liu, Yangjun
AU - Pompili, Cecilia
AU - Xu, Wei
AU - Xie, Shaohua
AU - Wang, Yaqin
AU - Liao, Jia
AU - Wei, Xing
AU - Xiang, Run
AU - Hu, Bin
AU - Tian, Bo
AU - Yang, Xiaozun
AU - Wang, Xiang
AU - Xiao, Ping
AU - Lai, Qi
AU - Wang, Xin
AU - Cao, Bangrong
AU - Wang, Qifeng
AU - Liu, Fang
AU - Liu, Xiaoqin
AU - Xie, Tianpeng
AU - Yang, Xiaojun
AU - Zhuang, Xiang
AU - Wu, Zhong
AU - Che, Guowei
AU - Li, Qiang
AU - Shi, Qiuling
N1 - Publisher Copyright:
© 2022 American Society of Clinical Oncology. All rights reserved.
PY - 2022/3/20
Y1 - 2022/3/20
N2 - PURPOSE We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery. METHODS Before surgery, patients with clinically diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score $ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of $ 4) at discharge. Per-protocol analyses were conducted. RESULTS Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median [interquartile range], 0 [0-2] v 2 [0-3]; P 5 .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median [interquartile range], 0 [0-0] v 0 [0-1]; P 5 .018). The intervention group had a lower complication rate than the control group (21.5% v 40.6%; P 5 .019). Surgeons spent a median of 3 minutes managing an alert. CONCLUSION PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.
AB - PURPOSE We aimed to evaluate the efficacy and feasibility of patient-reported outcome (PRO)-based symptom management in the early period after lung cancer surgery. METHODS Before surgery, patients with clinically diagnosed lung cancer were randomly assigned 1:1 to receive postoperative PRO-based symptom management or usual care. All patients reported symptoms on MD Anderson Symptom Inventory-Lung Cancer presurgery, daily postsurgery, and twice a week after discharge for up to 4 weeks via an electronic PRO system. In the intervention group, treating surgeons responded to overthreshold electronic alerts driven by any of the five target symptom scores (score $ 4 on a 0-10 scale for pain, fatigue, disturbed sleep, shortness of breath, and coughing). The control group patients received usual care and no alerts were generated. The primary outcome was the number of symptom threshold events (any target symptom with a score of $ 4) at discharge. Per-protocol analyses were conducted. RESULTS Of the 166 participants, 83 were randomly allocated to each group. At discharge, the intervention group reported fewer symptom threshold events than the control group (median [interquartile range], 0 [0-2] v 2 [0-3]; P 5 .007). At 4 weeks postdischarge, this difference was maintained between the intervention and control groups (median [interquartile range], 0 [0-0] v 0 [0-1]; P 5 .018). The intervention group had a lower complication rate than the control group (21.5% v 40.6%; P 5 .019). Surgeons spent a median of 3 minutes managing an alert. CONCLUSION PRO-based symptom management after lung cancer surgery showed lower symptom burden and fewer complications than usual care for up to 4 weeks postdischarge.
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U2 - 10.1200/JCO.21.01344
DO - 10.1200/JCO.21.01344
M3 - Article
C2 - 34995100
AN - SCOPUS:85126653447
SN - 0732-183X
VL - 40
SP - 988
EP - 996
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 9
ER -