Examining the Impact of a Web-Based Intervention to Promote Patient Activation in Chemotherapy-Induced Peripheral Neuropathy Assessment and Management
- 218 Downloads
Lack of activation in self-care can compromise a patient’s ability to monitor and manage cancer treatment-related side effects, such as chemotherapy-induced peripheral neuropathy (CIPN). The web-based Carevive® Care Planning System (CPS) was developed to promote evidence-based symptom assessment and treatment by enhancing patients’ involvement in their own care. The purpose of this single-arm, pre-test/post-test, prospective study was to examine whether the CPS can promote patient activation in CIPN symptom assessment and management. Seventy-five women with breast cancer receiving neurotoxic chemotherapy were recruited from a Comprehensive Cancer Center. Using standardized neuropathy measures embedded within the CPS, patients reported their CIPN symptoms over three consecutive clinical visits and completed the Patient Activation Measure (PAM) at the first and third visits. Mean changes in PAM scores between visits were compared using repeated measure analysis of covariance, adjusting for age. At baseline, patients were diagnosed with cancer within the past year (94.7%), highly activated (85% Level III/IV), and had a mean age of 51.3. PAM scores improved significantly from 67.15 (SD = 13.5; range = 47–100) at visit one to 69.29 (SD = 16.18; range = 47–100) (p = 0.02) (n = 62) at visit three. However, patients perceived the CPS to be of minimal value because it solely focused on CIPN and, for many, CIPN was not severe enough to motivate them to seek out symptom management information. Further research is needed to assess the utility of the CPS in promoting activation in the assessment and management of varying cancer treatment-related symptoms.
KeywordsChemotherapy-induced peripheral neuropathy Technology assessment Peripheral nervous system disease/chemically induced Cancer symptom management Patient activation
The authors would like to acknowledge Shraddha Pardesi, MS, BPharm for patient accrual; James P. Kelly, IV, BS, Elizabeth Edwards, BS, and Kelsey Kippe, BSN, RN for data collection; and Connie Visovsky, PhD, APRN-BC, FAAN for her assistance with preparing the Genentech grant application.
Compliance with Ethical Standards
Conflict of Interest and Source of Funding
This study was funded by Genentech Research Grant G-26378. The platform tested in this study was provided without cost by Carevive Systems, Inc.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 1.Hershman DL, Lacchetti C, Dworkin RH et al (2014) Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol 32(18):1941–1967. doi:10.1200/JCO.2013.54.0914 CrossRefPubMedGoogle Scholar
- 15.Basch E, Reeve BB, Mitchell SA, et al. 2014. Development of the National Cancer Institute’s patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE). J Natl Cancer Inst 106(9). doi:10.1093/jnci/dju244
- 19.Brooke J (1996) A quick and dirty usability scale. Usability Evaluation in Industry 189(194):4–7Google Scholar
- 22.R Development Core Team (2017). R: A language and environment for statistical computing. https://www.r-project.org. Accessed 9 Jan 2017
- 24.Bos-Touwen I, Schuurmans M, Monninkhof EM et al (2015) Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: a cross-sectional survey study. Wu W-CH, ed. PLoS One 10(5):e0126400. doi:10.1371/journal.pone.0126400 CrossRefPubMedPubMedCentralGoogle Scholar
- 25.Rogers E (2003) Diffusion of innovations, 5th edn. Free Press, New YorkGoogle Scholar