The following is a summary of “Technology-Assisted mHealth Caregiver Support to Manage Cancer Patient Symptoms: A Randomized Controlled Trial,” published in the July 2023 issue of the Pain and Symptom Management by Mooney et al.

Caregivers overseeing the management of symptoms in their family members with cancer during the provision of home hospice care frequently experience a sense of inadequate readiness and require guidance in patient care coaching. This study evaluated the effectiveness of an automated mobile health platform incorporating caregiver guidance on managing patient symptoms and nurse alerts for inadequately controlled symptoms. The primary outcome measure assessed the caregiver’s perception of the patient’s overall symptom severity during their hospice care and at weeks one, two, four, and eight. Secondary outcomes assessed the severity of individual symptoms.

Caregivers (n = 298) were randomly allocated to the Symptom Care at Home (SCH) intervention (n = 144) or standard hospice care (UC) (n = 154). All healthcare providers made daily calls to the automated system that evaluated the existence and intensity of 11 physical and psychosocial symptoms in patients nearing the end of their lives. SCH caregivers were provided automatic guidance on symptom management tailored to patients’ reported symptoms and severity levels. The hospice nurse was also informed about symptoms of moderate-to-severe intensity. The SCH intervention resulted in a mean reduction in symptoms, compared to usual care (UC), of 4.89 severity points (95% CI 2.86–6.92) (P < 0.001), indicating a moderate effect size (d = 0.55). The subchorionic hematoma benefit was also observed at each time point (P < 0.001– 0.020). 

There was a 38% decrease in the number of days where patients reported moderate-to-severe symptoms compared to usual care (UC) (P < 0.001), with 10 out of 11 signs showing a significant reduction in patients receiving standard-of-care treatment (SCH) compared to UC. Automated mobile health (mHealth) symptom reporting by caregivers, combined with customized caregiver coaching on symptom management and nurse notifications, mitigates physical and psychosocial symptoms experienced by cancer patients during home hospice. This innovative and effective strategy offers a promising avenue for enhancing end-of-life care.

Source: sciencedirect.com/science/article/abs/pii/S0885392423004001