title: Communicating advanced cancer patients' symptoms via the Internet: a pooled analysis of two randomized trials examining caregiver preparedness, physical burden, and negative mood.
abstract: BACKGROUND
  Using available communication technologies, clinicians may offer timely support to family caregivers in managing symptoms in patients with advanced cancer at home.
  
  
  OBJECTIVE
  To assess the effects of an online symptom reporting system on caregiver preparedness, physical burden, and negative mood.
  
  
  METHODS
  A pooled analysis of two randomized trials (NCT00214162 and NCT00365963) was conducted to compare caregiver outcomes at 6 and 12 months after intervention between two randomized, unblinded groups using General Linear Mixed Modeling. Caregivers in one group (Comprehensive Health Enhancement Support System-Only) were given access to an interactive cancer communication system, the Comprehensive Health Enhancement Support System. Those in the other group (Comprehensive Health Enhancement Support System + Clinician Report) received access to Comprehensive Health Enhancement Support System plus an online symptom reporting system called the Clinician Report. Clinicians of patients in the Comprehensive Health Enhancement Support System + Clinician Report group received e-mail alerts notifying them when a symptom distress was reported over a predetermined threshold.
  
  
  METHODS
  Dyads (n = 235) of advanced-stage lung, breast, and prostate cancer patients and their adult caregivers were recruited at five outpatient oncology clinics in the United States.
  
  
  RESULTS
  Caregivers in the Comprehensive Health Enhancement Support System + Clinician Report group reported less negative mood than those in the Comprehensive Health Enhancement Support System-Only group at both 6 months (p = 0.009) and 12 months (p = 0.004). Groups were not significantly different on caregiver preparedness or physical burden at either time point.
  
  
  CONCLUSIONS
  This study provides new evidence that by using an online symptom reporting system, caregivers may experience less emotional distress due to the Clinician Report's timely communication of caregiving needs in symptom management to clinicians.
authors.affiliation: Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, USA. chih@uwalumni.com
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Chih
authors.forename: Lori L
authors.initials: LL
authors.lastname: DuBenske
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hawkins
authors.forename: Roger L
authors.initials: RL
authors.lastname: Brown
authors.forename: Susan K
authors.initials: SK
authors.lastname: Dinauer
authors.forename: James F
authors.initials: JF
authors.lastname: Cleary
authors.forename: David H
authors.initials: DH
authors.lastname: Gustafson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003142:Communication; D017281:Cost of Illness; D005260:Female; D006801:Humans; D020407:Internet; D016014:Linear Models; D008175:Lung Neoplasms / Q000451:nursing / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010817:Physician-Patient Relations; D011471:Prostatic Neoplasms / Q000451:nursing / Q000523:psychology*; D013315:Stress, Psychological; D014481:United States