title: Remote patient-provider communication and quality of life: empirical test of a dialogic model of cancer care.
abstract: We examined the feasibility of a Cancer Care Dialogues Model, with daily telehealth interactions between patients at home and their care coordinator, who acted as an adjunct to the oncologist. The patient and the care coordinator used a home messaging device, connected via the ordinary telephone network. Thirty-four patients with a new diagnosis of cancer and whose treatment plan included chemotherapy taken at a single clinic were enrolled and followed for six months. The home messaging device collected information daily on common symptoms associated with chemotherapy. On average, the patients had the home messaging device for 120 days (range 30-180). The mean cooperation rate was 84% (range 4-100). No variables were significantly associated with patient cooperation in the dialogues over time. The health-related quality of life (HRQL) mean score at baseline was 73.9 (SD 15.4), and the mean score at six months was 78.4 (SD 14.5). After adjusting for demographic and clinical factors, there was a 6.5-point increase in HRQL score between the baseline and end of treatment, which represented an important clinical difference. Management of nervousness/worry over time through cancer care dialogues is important in maintaining HRQL and can be assisted by remote home messaging.
authors.affiliation: VA HSR&D/RR&D Rehabilitation Outcomes Research Center, North Florida/South Georgia Veterans Health System, Gainesville, FL 32608-1197, USA. Neale.Chumbler@med.va.gov
authors.forename: Neale R
authors.initials: NR
authors.lastname: Chumbler
authors.forename: William N
authors.initials: WN
authors.lastname: Mkanta
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
authors.forename: Linda
authors.initials: L
authors.lastname: Harris
authors.forename: Adam
authors.initials: A
authors.lastname: Darkins
authors.forename: Rita
authors.initials: R
authors.lastname: Kobb
authors.forename: Patricia
authors.initials: P
authors.lastname: Ryan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D034201:Computers, Handheld; D016903:Drug Monitoring; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D010346:Patient Care Management; D010349:Patient Compliance; D011369:Professional-Patient Relations; D011788:Quality of Life; D019114:Remote Consultation / Q000295:instrumentation