title: Feasibility of a Telehealth Educational Program on Self-Management of Pain and Fatigue in Adult Cancer Patients.
abstract: Pain and fatigue are common symptoms among cancer patients and often lead to substantial distress. Innovative self-management programs for pain and fatigue are needed.
  
  
  
  The primary objective was to assess the feasibility of a telehealth pain and fatigue self-management program among adult cancer patients. Secondary objectives included assessment of differences in patient characteristics, recruitment, and retention of patients based on two screening strategies: 1) navigator-collected, patient-reported pain or fatigue and 2) in-clinic, physician-identified pain or fatigue.
  
  
  
  This prospective, nonrandomized, pre-post evaluation assessed feasibility, which was defined as 50% of eligible patients choosing to participate and completing the intervention. Patient demographics and patient-reported outcomes (patient activation, distress, symptoms, and quality of life) were collected at baseline and study completion. Differences in baseline characteristics were compared between cohorts and for patients who did vs. did not graduate from the program.
  
  
  
  The program did not meet feasibility requirements because of only 34% of eligible patients choosing to participate. However, 50% of patients starting the program graduated. Differences in baseline characteristics and retention rates were noted by recruitment strategy. At baseline, 27.3% of navigated patients were at the highest activation level compared with 7.1% in the physician-referred, non-navigated patients (P = 0.17); more than 15% of non-completers were at the lowest activation level compared with 9% of completers (P = 0.85).
  
  
  
  Telehealth self-management program for pain and fatigue may be better accepted among selected segments of cancer patients. Larger scale studies are needed to assess the efficacy of this program in a more selective activated population.
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA. Electronic address: grocque@uabmc.edu.
authors.forename: Gabrielle B
authors.initials: GB
authors.lastname: Rocque
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Karina I
authors.initials: KI
authors.lastname: Halilova
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Allyson L
authors.initials: AL
authors.lastname: Varley
authors.affiliation: Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Courtney P
authors.initials: CP
authors.lastname: Williams
authors.affiliation: School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Taylor
authors.affiliation: Pack Health LLC, Birmingham, Alabama, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Masom
authors.affiliation: Pack Health LLC, Birmingham, Alabama, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Wright
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Partridge
authors.affiliation: Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, USA; Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Kvale
mesh_terms: D000368:Aged; D000072716:Cancer Pain / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005221:Fatigue / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000503:physiopathology / Q000628:therapy*; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D018579:Patient Selection; D011446:Prospective Studies; D000073278:Self-Management / Q000193:education*; D017216:Telemedicine / Q000379:methods; D016896:Treatment Outcome
keywords: Self-management; cancer; fatigue; pain; recruitment; telehealth