Telehealth serious illness care program for older adults with hematologic malignancies: a single-arm pilot study.

Autor:	LoCastro M; School of Medicine and Dentistry, University of Rochester, Rochester, NY., Mortaz-Hedjri S; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY., Wang Y; Department of Epidemiology, University of Rochester Medical Center, Rochester, NY., Mendler JH; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY., Norton S; School of Nursing, University of Rochester Medical Center, Rochester, NY., Bernacki R; Department of Palliative Care, Harvard Medical School, Boston, MA., Carroll T; Divisions of General Medicine and Palliative Care, University of Rochester Medical Center, Rochester, NY., Klepin H; Department of Hematology/Oncology, Wake Forest School of Medicine, Winston-Salem, NC., Liesveld J; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY., Huselton E; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY., Kluger B; Divisions of General Medicine and Palliative Care, University of Rochester Medical Center, Rochester, NY.; Department of Neurology, University of Rochester Medical Center, Rochester, NY., Loh KP; Division of Hematology/Oncology, Department of Medicine, James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Dec 26; Vol. 7 (24), pp. 7597-7607.
DOI:	10.1182/bloodadvances.2023011046
Abstrakt:	Abstract: Older patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) feel shocked and bewildered when diagnosed. Serious illness conversations (SICs) may increase disease understanding and preparations for the future. However, SICs often happen late, in part because of clinician-perceived patient discomfort. Telehealth may promote patient comfort by allowing SICs to take place at home. This study assesses the feasibility and usability of a telehealth-delivered Serious Illness Care Program (SICP) for older adults with AML and MDS. We conducted a single-arm pilot study including 20 older adults with AML and MDS. Feasibility was measured using retention rate, with >80% considered feasible. Usability was measured using telehealth usability questionnaire (TUQ; range, 1-7): >5 considered usable. We collected other outcomes including acceptability and disease understanding and conducted post-visit qualitative interviews to elicit feedback. Hypothesis testing was performed at α = 0.10 owing to the pilot nature and small sample size. Retention rate was 95% (19/20); mean TUQ scores were 5.9 (standard deviation [SD], 0.9) and 5.9 (SD, 1.1) for patients and caregivers, respectively. We found the SICP to be acceptable. The majority of patients found the SICP to be very or extremely worthwhile (88.2%; 15/17), and reported it increased closeness with their clinician (75.0%; 12/16). After their visit, patient estimates of curability, and overall life expectancy aligned more closely with those of their clinicians. In qualitative interviews, most patients said that they would recommend this program to others (89.5%, 17/19). This study demonstrated that delivery of the telehealth SICP to older patients with AML and MDS is feasible, usable, and acceptable. This trial is registered at www.clinicaltrials.gov as #NCT04745676. (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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