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Erschienen in: Supportive Care in Cancer 6/2019

20.09.2018 | Original Article

Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients

verfasst von: Alex J. Fauer, Flora Hoodin, Leah Lalonde, Josh Errickson, Lyndsey Runaas, Tracey Churay, Sajjad Seyedsalehi, Casiana Warfield, Grant Chappell, Kristina Brookshire, Dima Chaar, Ji Youn Shin, Michelle Byrd, John Magenau, David A. Hanauer, Sung Won Choi

Erschienen in: Supportive Care in Cancer | Ausgabe 6/2019

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Abstract

Purpose

We developed BMT Roadmap, a health information technology (HIT) application on a tablet, to address caregivers’ unmet needs with patient-specific information from the electronic health record. We conducted a preliminary feasibility study of BMT Roadmap in caregivers of adult and pediatric HSCT patients. The study was registered on ClinicalTrials.​gov (NCT03161665; NCT02409121).

Methods

BMT Roadmap was delivered to 39 caregivers of adult and pediatric patients undergoing first-time HSCT at a single study site. We assessed person-reported outcome measures (PROMs) at baseline (hospital admission), discharge, and day 100: usefulness of BMT Roadmap (Perceived Usefulness); activation (Patient Activation Measure-Caregiver version [PAM-C]); mental health ([POMS-2®]: depression, distress, vigor, and fatigue); anxiety (State-Trait Anxiety Inventory); and quality of life (Caregiver Quality of Life Index-Cancer [CQOLC]). To identify determinants of caregiver activation and quality of life, we used linear mixed models.

Results

BMT Roadmap was perceived useful and activation increased from baseline to discharge (p = 0.001). Further, burden decreased through discharge (p = 0.007). Overall, a pattern of increasing vigor and decreasing depression, distress, fatigue, and anxiety was apparent from baseline to discharge. However, overall quality of life lowered at discharge after accounting for BMT Roadmap use, depression, anxiety, and fatigue (p = 0.04).

Conclusions

BMT Roadmap was a feasible HIT intervention to implement in HSCT caregivers. BMT Roadmap was associated with increased activation and decreased burden, but quality of life lowered across hospitalization. Findings support the need to further develop caregiver-specific self-directed resources and provide them both inpatient and outpatient across the HSCT trajectory.
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Literatur
1.
2.
Zurück zum Zitat Simoneau TL, Mikulich-Gilbertson SK, Natvig C, Kilbourn K, Spradley J, Grzywa-Cobb R, Philips S, McSweeney P, Laudenslager ML (2013) Elevated peri-transplant distress in caregivers of allogeneic blood or marrow transplant patients. Psychooncology 22(9):2064–2070CrossRefPubMedPubMedCentral Simoneau TL, Mikulich-Gilbertson SK, Natvig C, Kilbourn K, Spradley J, Grzywa-Cobb R, Philips S, McSweeney P, Laudenslager ML (2013) Elevated peri-transplant distress in caregivers of allogeneic blood or marrow transplant patients. Psychooncology 22(9):2064–2070CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat El-Jawahri AR, Traeger LN, Kuzmuk K, Eusebio JR, Vandusen HB, Shin JA et al (2015) Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation. Cancer 121(6):951–959CrossRefPubMed El-Jawahri AR, Traeger LN, Kuzmuk K, Eusebio JR, Vandusen HB, Shin JA et al (2015) Quality of life and mood of patients and family caregivers during hospitalization for hematopoietic stem cell transplantation. Cancer 121(6):951–959CrossRefPubMed
4.
Zurück zum Zitat Bevans M, Sternberg EM (2012) Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. Jama 307(4):398–403CrossRefPubMedPubMedCentral Bevans M, Sternberg EM (2012) Caregiving burden, stress, and health effects among family caregivers of adult cancer patients. Jama 307(4):398–403CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Northouse LL, Katapodi MC, Schafenacker AM, Weiss D (2012) The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs 28(4):236–245CrossRefPubMed Northouse LL, Katapodi MC, Schafenacker AM, Weiss D (2012) The impact of caregiving on the psychological well-being of family caregivers and cancer patients. Semin Oncol Nurs 28(4):236–245CrossRefPubMed
6.
Zurück zum Zitat Kent EE, Rowland JH, Northouse L, Litzelman K, Chou WY, Shelburne N et al (2016) Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer 122(13):1987–1995CrossRefPubMed Kent EE, Rowland JH, Northouse L, Litzelman K, Chou WY, Shelburne N et al (2016) Caring for caregivers and patients: research and clinical priorities for informal cancer caregiving. Cancer 122(13):1987–1995CrossRefPubMed
7.
Zurück zum Zitat Institute of Medicine (2012) Best care at lower cost: the path to continuously learning health care in America. National Academy Press, Washington D.C Institute of Medicine (2012) Best care at lower cost: the path to continuously learning health care in America. National Academy Press, Washington D.C
8.
Zurück zum Zitat Abernethy AP, Etheredge LM, Ganz PA, Wallace P, German RR, Neti C, Bach PB, Murphy SB (2010) Rapid-learning system for cancer care. J Clin Oncol 28(27):4268–4274CrossRefPubMedPubMedCentral Abernethy AP, Etheredge LM, Ganz PA, Wallace P, German RR, Neti C, Bach PB, Murphy SB (2010) Rapid-learning system for cancer care. J Clin Oncol 28(27):4268–4274CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Maher M, Kaziunas E, Ackerman M, Derry H, Forringer R, Miller K, O’Reilly D, An LC, Tewari M, Hanauer DA, Choi SW (2016) User-centered design groups to engage patients and caregivers with a personalized health information technology tool. Biol Blood Marrow Transplant 22(2):349–358CrossRefPubMed Maher M, Kaziunas E, Ackerman M, Derry H, Forringer R, Miller K, O’Reilly D, An LC, Tewari M, Hanauer DA, Choi SW (2016) User-centered design groups to engage patients and caregivers with a personalized health information technology tool. Biol Blood Marrow Transplant 22(2):349–358CrossRefPubMed
11.
Zurück zum Zitat Maher M, Hanauer DA, Kaziunas E, Ackerman MS, Derry H, Forringer R, Miller K, O’Reilly D, An L, Tewari M, Choi SW (2015) A novel health information technology communication system to increase caregiver activation in the context of hospital-based pediatric hematopoietic cell transplantation: a pilot study. JMIR Res Protoc 4(4):e119CrossRefPubMedPubMedCentral Maher M, Hanauer DA, Kaziunas E, Ackerman MS, Derry H, Forringer R, Miller K, O’Reilly D, An L, Tewari M, Choi SW (2015) A novel health information technology communication system to increase caregiver activation in the context of hospital-based pediatric hematopoietic cell transplantation: a pilot study. JMIR Res Protoc 4(4):e119CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Runaas L, Hanauer D, Maher M, Bischoff E, Fauer A, Hoang T, Munaco A, Sankaran R, Gupta R, Seyedsalehi S, Cohn A, An L, Tewari M, Choi SW (2017) BMT roadmap: a user-centered design health information technology tool to promote patient-centered care in pediatric HCT. Biol Blood Marrow Transplant 23(5):813–819CrossRefPubMedPubMedCentral Runaas L, Hanauer D, Maher M, Bischoff E, Fauer A, Hoang T, Munaco A, Sankaran R, Gupta R, Seyedsalehi S, Cohn A, An L, Tewari M, Choi SW (2017) BMT roadmap: a user-centered design health information technology tool to promote patient-centered care in pediatric HCT. Biol Blood Marrow Transplant 23(5):813–819CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Davis F (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 13(3):319–340CrossRef Davis F (1989) Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q 13(3):319–340CrossRef
14.
Zurück zum Zitat Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005) Development and testing of a short form of the patient activation measure. Health Serv Res 40:1918–1930CrossRefPubMedPubMedCentral Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005) Development and testing of a short form of the patient activation measure. Health Serv Res 40:1918–1930CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Hibbard JH, Stockard J, Mahoney ER, Tusler M (2004) Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 39:1005–1026CrossRefPubMedPubMedCentral Hibbard JH, Stockard J, Mahoney ER, Tusler M (2004) Development of the patient activation measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Serv Res 39:1005–1026CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Weitzner MA, Jacobsen PB, Wagner H Jr, Friedland J, Cox C (1999) The Caregiver Quality of Life Index-Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res Int J Qual Life Asp Treat Care Rehab 8:55–63 Weitzner MA, Jacobsen PB, Wagner H Jr, Friedland J, Cox C (1999) The Caregiver Quality of Life Index-Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res Int J Qual Life Asp Treat Care Rehab 8:55–63
17.
Zurück zum Zitat Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto Spielberger CD, Gorsuch RL, Lushene R, Vagg PR, Jacobs GA (1983) Manual for the state-trait anxiety inventory. Consulting Psychologists Press, Palo Alto
18.
Zurück zum Zitat McNair DM, Loor M, Droppelman LF (1981) Profile of mood states. Educational and Industrial Testing Service, San Diego McNair DM, Loor M, Droppelman LF (1981) Profile of mood states. Educational and Industrial Testing Service, San Diego
19.
Zurück zum Zitat West BT, Welch KB, Galecki AT (2014) Linear mixed models: a practical guide using statistical software. 2, CRC Press West BT, Welch KB, Galecki AT (2014) Linear mixed models: a practical guide using statistical software. 2, CRC Press
20.
Zurück zum Zitat Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106(8):2912–2919CrossRefPubMedPubMedCentral Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B (2005) Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 106(8):2912–2919CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Li Q, Loke AY (2013) The positive aspects of caregiving for cancer patients: a critical review of the literature and directions for future research. Psychooncology 22(11):2399–2407CrossRefPubMed Li Q, Loke AY (2013) The positive aspects of caregiving for cancer patients: a critical review of the literature and directions for future research. Psychooncology 22(11):2399–2407CrossRefPubMed
22.
Zurück zum Zitat DuBenske LL, Gustafson DH, Namkoong K, Hawkins RP, Atwood AK, Brown RL et al (2014) CHESS improves cancer caregivers’ burden and mood: results of an eHealth RCT. Health Psychol 33(10):1261–1272CrossRefPubMed DuBenske LL, Gustafson DH, Namkoong K, Hawkins RP, Atwood AK, Brown RL et al (2014) CHESS improves cancer caregivers’ burden and mood: results of an eHealth RCT. Health Psychol 33(10):1261–1272CrossRefPubMed
23.
Zurück zum Zitat Runaas L, Hoodin F, Munaco A, Fauer A, Sankaran R, Churay T et al (2017) Journal of clinical oncology clinical cancer informatics. Accepted, In Press Runaas L, Hoodin F, Munaco A, Fauer A, Sankaran R, Churay T et al (2017) Journal of clinical oncology clinical cancer informatics. Accepted, In Press
24.
Zurück zum Zitat Bevans MF, Mitchell SA, Marden S (2008) The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). Support Care Cancer 16(11):1243–1254CrossRefPubMedPubMedCentral Bevans MF, Mitchell SA, Marden S (2008) The symptom experience in the first 100 days following allogeneic hematopoietic stem cell transplantation (HSCT). Support Care Cancer 16(11):1243–1254CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat Von Ah D, Spath M, Nielsen A, Fife B (2016) The caregiver’s role across the bone marrow transplantation trajectory. Cancer Nurs 39(1):E12–E19PubMed Von Ah D, Spath M, Nielsen A, Fife B (2016) The caregiver’s role across the bone marrow transplantation trajectory. Cancer Nurs 39(1):E12–E19PubMed
26.
Zurück zum Zitat Lopez L, Green AR, Tan-McGrory A, King R, Betancourt JR (2011) Bridging the digital divide in health care: the role of health information technology in addressing racial and ethnic disparities. Jt Comm J Qual Patient Saf 37(10):437–445CrossRefPubMed Lopez L, Green AR, Tan-McGrory A, King R, Betancourt JR (2011) Bridging the digital divide in health care: the role of health information technology in addressing racial and ethnic disparities. Jt Comm J Qual Patient Saf 37(10):437–445CrossRefPubMed
27.
Zurück zum Zitat Kim Y, Loscalzo MJ, Wellisch DK, Spillers RL (2006) Gender differences in caregiving stress among caregivers of cancer survivors. Psychooncology 15(12):1086–1092CrossRefPubMed Kim Y, Loscalzo MJ, Wellisch DK, Spillers RL (2006) Gender differences in caregiving stress among caregivers of cancer survivors. Psychooncology 15(12):1086–1092CrossRefPubMed
Metadaten
Titel
Impact of a health information technology tool addressing information needs of caregivers of adult and pediatric hematopoietic stem cell transplantation patients
verfasst von
Alex J. Fauer
Flora Hoodin
Leah Lalonde
Josh Errickson
Lyndsey Runaas
Tracey Churay
Sajjad Seyedsalehi
Casiana Warfield
Grant Chappell
Kristina Brookshire
Dima Chaar
Ji Youn Shin
Michelle Byrd
John Magenau
David A. Hanauer
Sung Won Choi
Publikationsdatum
20.09.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 6/2019
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4450-4

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