Evaluating a Video-Based, Personalized Webpage in Genitourinary Oncology Clinical Trials: A Phase 2 Randomized Trial.

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Journal

Journal of medical Internet research
ISSN: 1438-8871
Titre abrégé: J Med Internet Res
Pays: Canada
ID NLM: 100959882

Informations de publication

Date de publication:
02 05 2019
Historique:
received: 27 08 2018
accepted: 31 12 2018
revised: 08 12 2018
entrez: 3 5 2019
pubmed: 3 5 2019
medline: 15 2 2020
Statut: epublish

Résumé

The pace of drug discovery and approvals has led to expanding treatments for cancer patients. Although extensive research exists regarding barriers to enrollment in oncology clinical trials, there are limited studies evaluating processes to optimize patient education, oral anticancer therapy administration, and adherence for patients enrolled in clinical trials. In this study, we assess the feasibility of a video-based, personalized webpage for patients enrolled in genitourinary oncology clinical trials involving 1 or more oral anticancer therapy. The primary objective of this trial was to assess the differences in the number of patient-initiated violations in the intervention arm compared with a control arm over 4 treatment cycles. Secondary objectives included patient satisfaction, frequently asked questions by patients on the intervention arm, patient-initiated calls to study team members, and patient-reported stress levels. Eligible patients enrolling on a therapeutic clinical trial for a genitourinary malignancy were randomized 2:1 to the intervention arm or control arm. Patients randomized to the intervention arm received access to a video-based, personalized webpage, which included videos of patients' own clinic encounters with their providers, instructional videos on medication administration and side effects, and electronic versions of educational documents. A total of 99 patients were enrolled (89 were evaluable; 66 completed 4 cycles). In total, 71% (40/56) of patients in the intervention arm had 1 or more patient-initiated violation compared with 70% (23/33) in the control arm. There was no difference in the total number of violations across 4 cycles between the 2 arms (estimate=-0.0939, 95% CI-0.6295 to 0.4418, P value=.73). Median baseline satisfaction scores for the intervention and control arms were 72 and 73, respectively, indicating high levels of patient satisfaction in both arms. Median baseline patient-reported stress levels were 10 and 13 for the intervention and control arms, respectively, indicating low stress levels in both arms at baseline. This study is among the first to evaluate a video-based, personalized webpage that provides patients with educational videos and video recordings of clinical trial appointments. Despite not meeting the primary endpoint of reduced patient-initiated violations, this study demonstrates the feasibility of a video-based, personalized webpage in clinical trials. Future research assessing this tool might be better suited for realms outside of clinical trials and might consider the use of an endpoint that assesses patient-reported outcomes directly. A major limitation of this study was the lack of prior data for estimating the null hypothesis in this population.

Sections du résumé

BACKGROUND
The pace of drug discovery and approvals has led to expanding treatments for cancer patients. Although extensive research exists regarding barriers to enrollment in oncology clinical trials, there are limited studies evaluating processes to optimize patient education, oral anticancer therapy administration, and adherence for patients enrolled in clinical trials. In this study, we assess the feasibility of a video-based, personalized webpage for patients enrolled in genitourinary oncology clinical trials involving 1 or more oral anticancer therapy.
OBJECTIVE
The primary objective of this trial was to assess the differences in the number of patient-initiated violations in the intervention arm compared with a control arm over 4 treatment cycles. Secondary objectives included patient satisfaction, frequently asked questions by patients on the intervention arm, patient-initiated calls to study team members, and patient-reported stress levels.
METHODS
Eligible patients enrolling on a therapeutic clinical trial for a genitourinary malignancy were randomized 2:1 to the intervention arm or control arm. Patients randomized to the intervention arm received access to a video-based, personalized webpage, which included videos of patients' own clinic encounters with their providers, instructional videos on medication administration and side effects, and electronic versions of educational documents.
RESULTS
A total of 99 patients were enrolled (89 were evaluable; 66 completed 4 cycles). In total, 71% (40/56) of patients in the intervention arm had 1 or more patient-initiated violation compared with 70% (23/33) in the control arm. There was no difference in the total number of violations across 4 cycles between the 2 arms (estimate=-0.0939, 95% CI-0.6295 to 0.4418, P value=.73). Median baseline satisfaction scores for the intervention and control arms were 72 and 73, respectively, indicating high levels of patient satisfaction in both arms. Median baseline patient-reported stress levels were 10 and 13 for the intervention and control arms, respectively, indicating low stress levels in both arms at baseline.
CONCLUSIONS
This study is among the first to evaluate a video-based, personalized webpage that provides patients with educational videos and video recordings of clinical trial appointments. Despite not meeting the primary endpoint of reduced patient-initiated violations, this study demonstrates the feasibility of a video-based, personalized webpage in clinical trials. Future research assessing this tool might be better suited for realms outside of clinical trials and might consider the use of an endpoint that assesses patient-reported outcomes directly. A major limitation of this study was the lack of prior data for estimating the null hypothesis in this population.

Identifiants

pubmed: 31045501
pii: v21i5e12044
doi: 10.2196/12044
pmc: PMC6538310
doi:

Types de publication

Clinical Trial, Phase II Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e12044

Informations de copyright

©Rana McKay, Hannah Mills, Lillian Werner, Atish Choudhury, Toni Choueiri, Susanna Jacobus, Amanda Pace, Laura Polacek, Mark Pomerantz, Judith Prisby, Christopher Sweeney, Meghara Walsh, Mary-Ellen Taplin. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 02.05.2019.

Références

PLoS One. 2018 Oct 5;13(10):e0204599
pubmed: 30289884
Cochrane Database Syst Rev. 2011 Oct 05;(10):CD001431
pubmed: 21975733
J Health Soc Behav. 1983 Dec;24(4):385-96
pubmed: 6668417
Pediatr Transplant. 2005 Jun;9(3):381-90
pubmed: 15910397
Leuk Res. 2012 Jul;36(7):817-25
pubmed: 22364811
J Clin Oncol. 2016 Feb 10;34(5):469-78
pubmed: 26700123
Trials. 2015 May 27;16:231
pubmed: 26012700
JAMA. 2017 Jul 11;318(2):197-198
pubmed: 28586821
Expert Rev Anticancer Ther. 2016;16(4):423-32
pubmed: 26935964
Orthop J Sports Med. 2018 Jan 26;6(1):2325967117751418
pubmed: 29399589
Oncologist. 2017 Sep;22(9):1015-1019
pubmed: 28620092
Nicotine Tob Res. 2017 Mar 1;19(3):324-332
pubmed: 27836982
Cancer. 2012 Apr 1;118(7):1877-83
pubmed: 22009665
Trials. 2016 Jan 09;17:17
pubmed: 26745891
Trials. 2016 May 26;17(1):263
pubmed: 27229153
Qual Life Res. 2014 Apr;23(3):815-24
pubmed: 24062239
J Med Internet Res. 2018 Jun 26;20(6):e228
pubmed: 29945857
Psychooncology. 2007 Jun;16(6):507-16
pubmed: 16986176
Am J Clin Oncol. 1982 Dec;5(6):649-55
pubmed: 7165009
PLoS One. 2017 Mar 23;12(3):e0171952
pubmed: 28333925
Contemp Clin Trials. 2015 Nov;45(Pt A):41-54
pubmed: 26176884
Eur J Cancer Care (Engl). 2014 Jan;23(1):22-35
pubmed: 24079854
Cancer. 1983 Nov 1;52(9):1760-7
pubmed: 6616426
Semin Oncol Nurs. 2011 May;27(2):133-41
pubmed: 21514482
Am J Hematol. 2011 Jun;86(6):471-4
pubmed: 21538468
J Med Internet Res. 2011 Dec 05;13(4):e103
pubmed: 22138112
Oncol Nurs Forum. 2015 Mar;42(2):183-92
pubmed: 25806885
Health Qual Life Outcomes. 2003 Dec 16;1:79
pubmed: 14678568

Auteurs

Rana McKay (R)

University of California San Diego, La Jolla, CA, United States.

Hannah Mills (H)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Lillian Werner (L)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Atish Choudhury (A)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Toni Choueiri (T)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Susanna Jacobus (S)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Amanda Pace (A)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Laura Polacek (L)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Mark Pomerantz (M)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Judith Prisby (J)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Christopher Sweeney (C)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Meghara Walsh (M)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

Mary-Ellen Taplin (ME)

Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.

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