Abstract
Introduction: Promotion of self-efficacy can enhance engagement with health care and treatment adherence in patients with cancer. We report the outcomes of a pilot trial of a digital health coach intervention in patients with leukemia with the aim of improving self-efficacy. Methods: Adult patients with newly diagnosed acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) were randomized 1:1 to a digital health coach intervention or standard of care. The primary outcome of self-efficacy was measured by the Cancer Behavior Inventory (CBI) score. Results: A total of 147 patients (37 AML, 110 CLL) were enrolled from July 2020 to December 2022. In the AML cohort, there was a mean increase in CBI score of 7.03 in the digital health coaching arm compared to a mean decrease of −3.57 in the control arm at 30 days (p = 0.219). There were no significant associations between the intervention and other patient-reported outcomes for patients with CLL. Conclusion: There were numerical, but not statistically significant increases in self-efficacy metrics in AML patients who received digital health coaching. Although this trial was underpowered due to enrollment limitations during a pandemic, digital health coaching may provide benefit to patients with hematologic malignancy and warrants further investigation.
Journal Section:
Patient Reported Outcomes
References
1.
Kantarjian
HM
, Kadia
TM
, DiNardo
CD
, Welch
MA
, Ravandi
F
. Acute myeloid leukemia: treatment and research outlook for 2021 and the MD Anderson approach
. Cancer
. 2021
;127
(8
):1186
–207
. 2.
Shadman
M
. Diagnosis and treatment of chronic lymphocytic leukemia: a review
. JAMA
. 2023
;329
(11
):918
–32
. 3.
Burger
JA
. Integrating new therapies for chronic lymphocytic leukemia
. Cancer J
. 2021
;27
(4
):275
–85
. 4.
Portenoy
RK
. Cancer-related fatigue: an immense problem
. Oncologist
. 2000
;5
(5
):350
–2
. 5.
Passik
SD
, Dugan
W
, McDonald
MV
, Rosenfeld
B
, Theobald
DE
, Edgerton
S
. Oncologists’ recognition of depression in their patients with cancer
. J Clin Oncol
. 1998
;16
(4
):1594
–600
. 6.
Schumacher
A
, Wewers
D
, Heinecke
A
, Sauerland
C
, Koch
OM
, van de Loo
J
, et al. Fatigue as an important aspect of quality of life in patients with acute myeloid leukemia
. Leuk Res
. 2002
;26
(4
):355
–62
. 7.
Schumacher
A
, Kessler
T
, Büchner
T
, Wewers
D
, Van De Loo
J
. Quality of life in adult patients with acute myeloid leukemia receiving intensive and prolonged chemotherapy: a longitudinal study
. Leukemia
. 1998
;12
(4
):586
–92
. 8.
Basch
E
, Schrag
D
, Henson
S
, Jansen
J
, Ginos
B
, Stover
AM
, et al. Effect of electronic symptom monitoring on patient-reported outcomes among patients with metastatic cancer: a randomized clinical trial
. JAMA
. 2022
;327
(24
):2413
–22
. 9.
Schuit
AS
, Holtmaat
K
, Lissenberg-Witte
BI
, Eerenstein
SEJ
, Zijlstra
JM
, Eeltink
C
, et al. Efficacy of the eHealth application Oncokompas, facilitating incurably ill cancer patients to self-manage their palliative care needs: a randomized controlled trial
. Lancet Reg Health Eur
. 2022
;18
:100390
. 10.
Wood
WA
, Bailey
C
, Castrogivanni
B
, Mehedint
D
, Bryant
AL
, Lavin
K
, et al. Piloting HealthScore: feasibility and acceptability of a clinically integrated health coaching program for people living with cancer
. Cancer Med
. 2023
;12
(7
):8804
–14
. 11.
Gudmundsson
GH
, Mészáros
J
, Björnsdóttir
ÁE
, Ámundadóttir
ML
, Thorvardardottir
GE
, Magnusdottir
E
, et al. Evaluating the feasibility of a digital therapeutic program for patients with cancer during active treatment: pre-post interventional study
. JMIR Form Res
. 2022
;6
(10
):e39764
. 12.
Van Den Berg
SW
, Gielissen
MFM
, Custers
JAE
, Van Der Graaf
WTA
, Ottevanger
PB
, Prins
JB
. BREATH: web-based self-management for psychological adjustment after primary breast cancer-results of a multicenter randomized controlled trial
. J Clin Oncol
. 2015
;33
(25
):2763
–71
. 13.
Novrianda
D
, Herini
ES
, Haryanti
F
, Supriyadi
E
, Lazuardi
L
. Chemo assist for children mobile health application to manage chemotherapy-related symptoms in acute leukemia in Indonesia: a user-centered design approach
. BMC Pediatr
. 2023
;23
(1
):274
. 14.
LeBlanc
MR
, LeBlanc
TW
, Yang
Q
, McLaughlin
J
, Irish
K
, Smith
SK
. A mobile app to support self-management in patients with multiple myeloma or chronic lymphocytic leukemia: pilot randomized controlled trial
. JMIR Cancer
. 2023
;9
:e44533
. 15.
Banerjee
R
, Huang
CY
, Ryan
C
, Lee
A
, Brassil
KJ
, Moore
J
, et al. Randomized phase 2 study of digital life coaching during transplantation for myeloma
. Bone Marrow Transplant
. 2023
;58
(12
):1406
–9
. 16.
Berry
DL
, Hong
F
, Halpenny
B
, Partridge
AH
, Fann
JR
, Wolpin
S
, et al. Electronic self-report assessment for cancer and self-care support: results of a multicenter randomized trial
. J Clin Oncol
. 2014
;32
(3
):199
–205
. 17.
Handley
N
, Wen
K-Y
, Gomaa
S
, Brassil
KJ
, Jackson
L
, Dicker
AP
. Exploring the role of digital health coaching for men with prostate cancer
. J Clin Oncol
. 2021
;39
(15_Suppl
):TPS1586
. 18.
Handley
N
, Wen
KY
, Gomaa
S
, Shimada
A
, Leiby
B
, Brassil
KJ
, et al. Outcomes of a pilot study exploring the role of digital health coaching for men with prostate cancer
. J Clin Oncol
. 2021
;39
(28_Suppl
):102
. 19.
Banerjee
R
, Huang
CY
, Dunn
L
, Knoche
J
, Ryan
C
, Brassil
K
, et al. Digital life coaching during stem cell transplantation: development and usability study
. JMIR Form Res
. 2022
;6
(3
):e33701
. 20.
Merluzzi
TV
, Philip
EJ
, Heitzmann Ruhf
CA
, Liu
H
, Yang
M
, Conley
CC
. Self-efficacy for coping with cancer: revision of the cancer behavior inventory (version 3.0)
. Psychol Assess
. 2018
;30
(4
):486
–99
. 21.
Cella
DF
, Tulsky
DS
, Gray
G
, Sarafian
B
, Linn
E
, Bonomi
A
, et al. The functional assessment of cancer therapy scale: development and validation of the general measure
. J Clin Oncol
. 1993
;11
(3
):570
–9
. 22.
Cella
D
, Jensen
SE
, Webster
K
, Hongyan
D
, Lai
JS
, Rosen
S
, et al. Measuring health-related quality of life in leukemia: the functional assessment of cancer therapy: leukemia (FACT-Leu) questionnaire
. Value Health
. 2012
;15
(8
):1051
–8
. 23.
Peipert
JD
, Yount
SE
, Efficace
F
, Loefgren
C
, Pierson
R
, He
J
, et al. Validation of the Functional Assessment of Cancer Therapy–Leukemia instrument in patients with acute myeloid leukemia who are not candidates for intensive therapy
. Cancer
. 2020
;126
(15
):3542
–51
. 24.
Wang
XS
, Mendoza
TR
, Broadway
JB
, Mobley
GM
, Keating
M
, Cleeland
CS
, et al. Symptom profiles in patients with chronic lymphocytic leukemia: validation and application of the M. D. Anderson symptom inventory
. Blood
. 2009
;114
(22
):1393
. 25.
Cleeland
CS
, Mendoza
TR
, Wang
XS
, Chou
C
, Harle
MT
, Morrissey
M
, et al. Assessing symptom distress in cancer patients: the M. D. Anderson Symptom Inventory
. Cancer
. 2000
;89
(7
):1634
–46
. 26.
Gabrilove
JL
, Perez
EA
, Tomita
DK
, Rossi
G
, Cleeland
CS
. Assessing symptom burden using the M. D. Anderson symptom inventory in patients with chemotherapy-induced anemia: results of a multicenter, open-label study (SURPASS) of patients treated with darbepoetin-alpha at a dose of 200 microg every 2 weeks
. Cancer
. 2007
;110
(7
):1629
–40
. 27.
Gabrilove
JL
, Perez
EA
, Tomita
DK
, Rossi
G
, Cleeland
CS
. Assessing symptom burden using the M. D. Anderson symptom inventory in patients with chemotherapy-induced anemia: results of a multicenter, open-label study (SURPASS) of patients treated with darbepoetin-alpha at a dose of 200 microg every 2 weeks
. Cancer
. 2007
;110
(7
):1629
–40
. 28.
Negussie
F
, Giru
BW
, Yusuf
NT
, Gela
D
. Psychological distress and associated factors among cancer patients in public hospitals, Addis Ababa, Ethiopia: a cross-sectional study
. BMC Psychol
. 2023
;11
(1
):41
. 29.
Peters
L
, Brederecke
J
, Franzke
A
, de Zwaan
M
, Zimmermann
T
. Psychological distress in a sample of inpatients with mixed cancer: a cross-sectional study of routine clinical data
. Front Psychol
. 2020
;11
:591771
. 30.
Maguire
R
, McCann
L
, Kotronoulas
G
, Kearney
N
, Ream
E
, Armes
J
, et al. Real time remote symptom monitoring during chemotherapy for cancer: European Multicentre Randomised Controlled Trial (eSMART)
. The BMJ
. 2021
;374
:n1647
. 31.
Leach
CR
, Hudson
SV
, Diefenbach
MA
, Wiseman
KP
, Sanders
A
, Coa
K
, et al. Cancer health self-efficacy improvement in a randomized controlled trial
. Cancer
. 2022
;128
(3
):597
–605
. © 2024 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2024
You do not currently have access to this content.
