Telenursing Model for Management of Chemotherapy Side Effects

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DESCRIPTION (provided by applicant): The goal of this specific project is to develop a cost-effective proactive telenursing system for the management of chemotherapy side effects. Patients will use this system to report health status on a daily basis during treatment, either on the Web or via interactive voice response system over the phone. Depending on the reported severity, the system may deliver just-in-time, evidence-based, context-sensitive patient education materials tailored to the patient's disease status and treatment regimen, and/or alert the oncology clinical care team to provide timely remote monitoring and consultation. Our Phase I aims are to (1) design a telenursing model with the special focus on tailored patient instructions via systematic literature review, web resource review, focus group discussions, and personal interviews; and (2) develop a working prototype based on the resultant telenursing model and conduct controlled pilot study in realistic settings to evaluate technical feasibility, the acceptance level by providers and patients, and the effects on clinical outcomes and perceived intervention effectiveness. The initial focus of the Phase I feasibility study is on neutropenia, fatigue and nausea, three of the common chemotherapy side effects, for lymphoma patients and will be extended to other side effects and cancer sites in Phase II. This project is consistent with our long-term strategic direction to improve access to care, promote patient self- management, facilitate provider-patient communication, and ultimately improve clinical outcomes and reduce healthcare costs with multidisciplinary approaches integrating telehealth and e-health technologies, evidence- based medicine, patient-reported outcomes methodologies, and patient education research. The proposed work is intended to improve access to care, promote patient self-management, facilitate provider-patient communication, and ultimately improve clinical outcomes and reduce healthcare costs. The effort is of particular public health interest since with the aging population the number of oncology patients is expected to increase. Also, telenursing addresses significant access to care issues for patients in remote rural locations as well as frail or disabled patients in urban settings.