Cancer survivorship care for young adults: a risk-stratified, multicenter randomized controlled trial to improve symptoms
| Autor: | Syrjala, Karen L, Walsh, Casey A, Yi, Jean C, Leisenring, Wendy M, Rajotte, Emily Jo, Voutsinas, Jenna, Ganz, Patricia A, Jacobs, Linda A, Palmer, Steven C, Partridge, Ann, Baker, K Scott |
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| Rok vydání: | 2022 |
| Předmět: |
Adult
Adolescent AYA Clinical Trials and Supportive Activities Oncology and Carcinogenesis Survivorship 7.3 Management and decision making Young Adult Cancer Survivors 7.1 Individual care needs Clinical Research Neoplasms Behavioral and Social Science Humans Oncology & Carcinogenesis Fatigue Cancer Prevention Rehabilitation Self Care Young adult Mental Health Survivorship care plan Randomized controlled trial Cancer survivor Quality of Life Risk-stratified Public Health and Health Services Management of diseases and conditions |
| Zdroj: | Journal of cancer survivorship : research and practice, vol 16, iss 5 |
| Popis: | PurposeYoung adult (YA) cancer survivors have high rates of adverse health and psychosocial outcomes. This risk-stratified, multicenter, randomized controlled trial (RCT) compared a self-management survivorship intervention to usual care in YA survivors with symptoms of cancer-related distress, insomnia, fatigue, pain, and/or depression.MethodsEligibility included age 18-39 at diagnosis with an invasive malignancy in the previous 1-5years. Baseline assessment determined "high need" participants, with 2-5 elevated targeted symptoms. We randomized high need participants to intervention or usual care and offered intervention participants a survivorship clinic visit, which included mutually decided action plans for symptoms. Follow-up calls at 1 and 3months after the clinic visit reviewed action plan progress. Outcomes compared rates of improved symptoms for intervention vs usual care at 6months and 12months.ResultsN = 344 completed baseline assessment, with n = 147 (43%) categorized as high need and randomized. Of n = 73 randomized to the intervention, n = 42 (58%) did not attend their survivorship clinic visit. In intent-to-treat analyses, aggregate symptom scores did not differ between arms, though distress improved for 46% in the intervention arm at 6months compared to 18% in usual care (p = 0.03) among those with elevated distress at baseline.ConclusionsDistress improved for YAs who received self-management survivorship care. However, the study demonstrates a need for alternative strategies for providing YA survivorship care.Trial registrationNCT02192333 IMPLICATIONS FOR CANCER SURVIVORS: While YA survivors demonstrate some improved distress when provided survivorship care, to make care accessible and effective, they require options such as remote delivery of care. |
| Databáze: | OpenAIRE |
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