Cancer survivorship care for young adults: a risk-stratified, multicenter randomized controlled trial to improve symptoms.
AYA
Cancer survivor
Randomized controlled trial
Risk-stratified
Survivorship care plan
Young adult
Journal
Journal of cancer survivorship : research and practice
ISSN: 1932-2267
Titre abrégé: J Cancer Surviv
Pays: United States
ID NLM: 101307557
Informations de publication
Date de publication:
10 2022
10 2022
Historique:
received:
19
04
2021
accepted:
24
08
2021
pubmed:
1
10
2021
medline:
24
9
2022
entrez:
30
9
2021
Statut:
ppublish
Résumé
Young adult (YA) cancer survivors have high rates of adverse health and psychosocial outcomes. This risk-stratified, multicenter, randomized controlled trial (RCT) compared a self-management survivorship intervention to usual care in YA survivors with symptoms of cancer-related distress, insomnia, fatigue, pain, and/or depression. Eligibility included age 18-39 at diagnosis with an invasive malignancy in the previous 1-5 years. Baseline assessment determined "high need" participants, with 2-5 elevated targeted symptoms. We randomized high need participants to intervention or usual care and offered intervention participants a survivorship clinic visit, which included mutually decided action plans for symptoms. Follow-up calls at 1 and 3 months after the clinic visit reviewed action plan progress. Outcomes compared rates of improved symptoms for intervention vs usual care at 6 months and 12 months. N = 344 completed baseline assessment, with n = 147 (43%) categorized as high need and randomized. Of n = 73 randomized to the intervention, n = 42 (58%) did not attend their survivorship clinic visit. In intent-to-treat analyses, aggregate symptom scores did not differ between arms, though distress improved for 46% in the intervention arm at 6 months compared to 18% in usual care (p = 0.03) among those with elevated distress at baseline. Distress improved for YAs who received self-management survivorship care. However, the study demonstrates a need for alternative strategies for providing YA survivorship care. NCT02192333 IMPLICATIONS FOR CANCER SURVIVORS: While YA survivors demonstrate some improved distress when provided survivorship care, to make care accessible and effective, they require options such as remote delivery of care.
Identifiants
pubmed: 34590205
doi: 10.1007/s11764-021-01105-8
pii: 10.1007/s11764-021-01105-8
pmc: PMC9438455
mid: NIHMS1833130
doi:
Banques de données
ClinicalTrials.gov
['NCT02192333']
Types de publication
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1149-1164Subventions
Organisme : NCI NIH HHS
ID : U01 CA246659
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA215134
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA092408
Pays : United States
Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
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