• Kathi Mooney, Meagan S Whisenant, Christina M Wilson, Lorinda A Coombs, Jennifer Lloyd, Natalya Alekhina, Elizabeth A Sloss, Mary Steinbach, Ann Marie Moraitis, Patricia Berry, Eli Iacob, and Gary Donaldson.
• College of Nursing and Huntsman Cancer Institute (KM, JL, MS) University of Utah, Salt Lake City, Utah, USA. Electronic address: kathi.mooney@nurs.utah.edu.
• J Pain Symptom Manage. 2023 Jul 1; 66 (1): 334333-43.

ContextCaregivers managing symptoms of family members with cancer during home hospice care, often feel ill-prepared and need patient care coaching.ObjectivesThis study tested the efficacy of an automated mHealth platform that included caregiver coaching on patient symptom care and nurse notifications of poorly controlled symptoms. The primary outcome was caregiver perception of patients' overall symptom severity throughout hospice care and at weeks one, two, four, and eight. Secondary outcomes compared individual symptom severity.MethodsCaregivers (n = 298) were randomly assigned to the Symptom Care at Home (SCH) intervention (n = 144) or usual hospice care (UC) (n = 154). All caregivers placed daily calls to the automated system that assessed the presence and severity of 11 end-of-life patient physical and psychosocial symptoms. SCH caregivers received automated coaching on symptom care based on reported patient symptoms and their severity. Moderate-to-severe symptoms were also relayed to the hospice nurse.ResultsThe SCH intervention produced a mean overall symptom reduction benefit, over UC, of 4.89 severity points (95% CI 2.86-6.92) (P < 0.001), with a moderate effect size (d = 0.55). The SCH benefit also occurred at each timepoint (P < 0.001- 0.020). There was a 38% reduction in days reporting moderate-to-severe patient symptoms compared to UC (P < 0.001) with 10/11 symptoms significantly reduced in SCH compared to UC.ConclusionAutomated mHealth symptom reporting by caregivers, paired with tailored caregiver coaching on symptom management and nurse notifications, reduces cancer patients' physical and psychosocial symptoms during home hospice, providing a novel and efficient approach to improving end-of-life care.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

15 keywords...

hide…