Outcomes of Home Telemonitoring for Patients with Lung Cancer Using Intention-to-Treat Approach

2.50
Hdl Handle:
http://hdl.handle.net/10755/308670
Category:
Abstract
Type:
Presentation
Title:
Outcomes of Home Telemonitoring for Patients with Lung Cancer Using Intention-to-Treat Approach
Author(s):
Chen, Yea-Jyh; Narsavage, Georgia L.; Sterns, Anthony A.; Forth, Tara; Petitte, Trisha M.; Coole, Charles
Lead Author STTI Affiliation:
Alpha Mu
Author Details:
Yea-Jyh Chen, PhD, RN, ychen58@kent.edu; Georgia L. Narsavage, PhD, CRNP, CNS; Anthony A. Sterns, PhD; Tara Forth, BSN, BA; Trisha M. Petitte, MSN, FNP-BC; Charles Coole, BA
Abstract:

Session presented on: Monday, November 18, 2013

Introduction: The purpose of this analysis is to better understand telemonitoring effectiveness using intention-to-treat (ITT) analysis in rural Appalachia with limited healthcare access/service. Non-adherence to home-treatment in patients appeared substantial. Home-telemonitoring to enhance self-management by lung cancer patients was unknown. Collecting data, even with home-telemonitoring, for a fragile patient population living in rural settings was a challenge.

Method: A pilot study of home-telemonitoring (randomized clinical trial) enrolled 41 patients with lung cancer from a university hospital/cancer center. Healthcare utilization and patient outcomes, including functional status (PFSS-11), quality of life (QOL; EQ5D VAS), # ER visits/ rehospitalizations were recorded for 60-days post-hospital discharge to determine differences between groups. The ITT analytic approach was used to evaluate outcome differences for patients using compliance with data-reporting (>80% vs. <80% completion of study data). More than half of the sample (56%) was compliant (C) versus 44% non-compliant (NC).

Results: Nonparametric tests indicated no baseline differences between groups. Telemonitored group participants were more compliant than control (66.7% vs. 45%) with data reporting. At 60-days post-hospital discharge, NC-patients used more acute-care services than C-patients (frequency—ER visit: 8>7; rehospitalization: 11>7); C-patients made more calls to doctors and nurses than NC-patients (doctor calls:12> 5;nurse calls:42>13). Compliance with telemonitoring was greater when cancer was diagnosed 3) and QOL higher (66.7% > 60). Although not statistically significant (p >.05), results trended to more positive outcomes for telemonitoring compared to control.

Conclusion: Data suggest improved outcomes with home telemonitoring and lower acute-care utilization. As a pilot, sample size was limited and lack of statistical significance anticipated. The pilot supports using this RCT protocol for a larger study to validate outcomes. Also, enrolling earlier stage oncology patients might maximize intervention benefits and minimize attrition.

Keywords:
home telemonitoring; intention-to-treat analysis; lung cancer
Repository Posting Date:
19-Dec-2013
Date of Publication:
19-Dec-2013
Conference Date:
2013
Conference Name:
42nd Biennial Convention
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriott

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleOutcomes of Home Telemonitoring for Patients with Lung Cancer Using Intention-to-Treat Approachen_GB
dc.contributor.authorChen, Yea-Jyhen_GB
dc.contributor.authorNarsavage, Georgia L.en_GB
dc.contributor.authorSterns, Anthony A.en_GB
dc.contributor.authorForth, Taraen_GB
dc.contributor.authorPetitte, Trisha M.en_GB
dc.contributor.authorCoole, Charlesen_GB
dc.contributor.departmentAlpha Muen_GB
dc.author.detailsYea-Jyh Chen, PhD, RN, ychen58@kent.edu; Georgia L. Narsavage, PhD, CRNP, CNS; Anthony A. Sterns, PhD; Tara Forth, BSN, BA; Trisha M. Petitte, MSN, FNP-BC; Charles Coole, BAen_GB
dc.identifier.urihttp://hdl.handle.net/10755/308670-
dc.description.abstract<p>Session presented on: Monday, November 18, 2013</p><b>Introduction:</b> The purpose of this analysis is to better understand telemonitoring effectiveness using intention-to-treat (ITT) analysis in rural Appalachia with limited healthcare access/service. Non-adherence to home-treatment in patients appeared substantial. Home-telemonitoring to enhance self-management by lung cancer patients was unknown. Collecting data, even with home-telemonitoring, for a fragile patient population living in rural settings was a challenge. <p><b>Method: </b>A pilot study of home-telemonitoring (randomized clinical trial) enrolled 41 patients with lung cancer from a university hospital/cancer center. Healthcare utilization and patient outcomes, including functional status (PFSS-11), quality of life (QOL; EQ5D VAS), # ER visits/ rehospitalizations were recorded for 60-days post-hospital discharge to determine differences between groups. The ITT analytic approach was used to evaluate outcome differences for patients using compliance with data-reporting (>80% vs. <80% completion of study data). More than half of the sample (56%) was compliant (C) versus 44% non-compliant (NC). <p><b>Results:</b> Nonparametric tests indicated no baseline differences between groups. Telemonitored group participants were more compliant than control (66.7% vs. 45%) with data reporting. At 60-days post-hospital discharge, NC-patients used more acute-care services than C-patients (frequency—ER visit: 8>7; rehospitalization: 11>7); C-patients made more calls to doctors and nurses than NC-patients (doctor calls:12> 5;nurse calls:42>13). Compliance with telemonitoring was greater when cancer was diagnosed <one year (92%), dyspnea and pain were lower (80% NRS<5), functioning better (58.3% PFSS-11 mean score >3) and QOL higher (66.7% > 60). Although not statistically significant (p >.05), results trended to more positive outcomes for telemonitoring compared to control. <p><b>Conclusion</b>: Data suggest improved outcomes with home telemonitoring and lower acute-care utilization. As a pilot, sample size was limited and lack of statistical significance anticipated. The pilot supports using this RCT protocol for a larger study to validate outcomes. Also, enrolling earlier stage oncology patients might maximize intervention benefits and minimize attrition.en_GB
dc.subjecthome telemonitoringen_GB
dc.subjectintention-to-treat analysisen_GB
dc.subjectlung canceren_GB
dc.date.available2013-12-19T17:34:32Z-
dc.date.issued2013-12-19-
dc.date.accessioned2013-12-19T17:34:32Z-
dc.conference.date2013en_GB
dc.conference.name42nd Biennial Conventionen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationIndianapolis, Indiana, USAen_GB
dc.description42nd Biennial Convention 2013 Theme: Give Back to Move Forward. Held at the JW Marriotten_GB
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