Symptom management interventions influence unscheduled health services use among cancer survivors and caregivers

Authors

Terry Badger, Advanced Nursing Practice and Science Division, University of Arizona College of Nursing, Tucson, AZ, USA. tbadger@arizona.edu.
Chris Segrin, Department of Communications, University of Arizona, Tucson, AZ, USA.
Tracy E. Crane, University of Miami Miller School of Medicine, Miami, FL, USA.
Pavani Chalasani, Division of Hematology-Oncology, George Washington University, Washington, DC, USA.
Waqas Arslan, College of Medicine, University of Arizona, Phoenix, AZ, USA.
Mary Hadeed, Advanced Nursing Practice and Science Division, University of Arizona College of Nursing, Tucson, AZ, USA.
Nathan Cunicelli, Advanced Nursing Practice and Science Division, University of Arizona College of Nursing, Tucson, AZ, USA.
Charles W. Given, Michigan State University College of Nursing, East Lansing, MI, USA.
Alla Sikorskii, Department of Psychiatry, Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA.

Document Type

Journal Article

Publication Date

11-29-2024

Journal

Journal of cancer survivorship : research and practice

DOI

10.1007/s11764-024-01723-y

Keywords

Anxiety; Cancer survivors and caregivers; Cancer survivorship; Depressive symptoms; Symptom management; Unscheduled health services use

Abstract

PURPOSE: Three sequences of telephone symptom management interventions were tested on use of unscheduled health services among cancer survivors with depressive or anxiety symptoms during treatment (N = 334) and their informal caregivers (N = 333). METHODS: The three 12-week intervention sequences were as follows: (1) Symptom Management and Survivorship Handbook (SMSH), (2) a combined 8-week SMSH + Telephone Interpersonal Counseling (TIPC) followed by SMSH for 4 weeks, and (3) SMSH for 4 weeks followed by a combined SMSH + TIPC if no response to SMSH alone. Survivor-caregiver dyads were first randomized to SMSH or a combined SMSH + TIPC. If the survivor's depressive or anxiety symptoms persisted after 4 weeks of SMSH alone, the dyad was randomized the second time to continue with SMSH alone or TIPC was added to SMSH. All participants were assessed at baseline and 13 and 17 weeks. Health service use was compared between randomized groups and among the three sequences. RESULTS: Survivors were 60.2 years of age, 79% were female, and 41% were Hispanic. Caregivers were 54.8 years of age; 67% were female. The significantly lower rate of emergency department (ED) or urgent care visits for survivors was found in the SMSH + TIPC intervention sequence compared to the SMSH alone in the second randomization and for the third intervention sequence compared to the first. CONCLUSIONS: Adding TIPC to SMSH after week 4 when survivors experienced persisting depressive or anxiety symptoms reduced ED/urgent care visits compared to SMSH alone. IMPLICATIONS FOR CANCER SURVIVORS: Managing depression and anxiety symptoms may help prevent ED/urgent care visits and worsening of other symptoms.

APA Citation

Badger, Terry; Segrin, Chris; Crane, Tracy E.; Chalasani, Pavani; Arslan, Waqas; Hadeed, Mary; Cunicelli, Nathan; Given, Charles W.; and Sikorskii, Alla, "Symptom management interventions influence unscheduled health services use among cancer survivors and caregivers" (2024). GW Authored Works. Paper 5959.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5959

Department

Medicine