A personally tailored, automated telephone symptom management intervention did not significantly improve overall symptom burden or confidence in symptom self-management compared to a nontailored newsletter among long-term prostate cancer survivors.
RCT (n=556)
Open-label
Computer-generated, stratified by original treatment
Yes
Does a personally tailored, automated telephone symptom management intervention improve symptom burden and confidence in self-management in long-term prostate cancer survivors?
A tailored automated telephone symptom management intervention did not significantly improve overall symptom burden compared to usual care with a newsletter in long-term prostate cancer survivors, though it improved coping appraisal.
Effect estimate: Adjusted mean difference 2.2 (95% CI -0.5 to 4.9)
Absolute Event Rate: 63.4% vs 61.8%
p-value: p=0.11
PURPOSE This randomized clinical trial compared a personally tailored, automated telephone symptom management intervention to improve self-management among long-term survivors of prostate cancer with usual care enhanced with a nontailored newsletter about symptom management. We hypothesized that intervention-group participants would have more confident symptom self-management and reduced symptom burden. METHODS A total of 556 prostate cancer survivors who, more than 1 year after treatment, were experiencing symptom burden were recruited from April 2015 to February 2017 across four Veterans Affairs sites. Participants were randomly assigned to intervention (n = 278) or usual care (n = 278) groups. We compared differences in the primary (symptom burden according to Expanded Prostate Cancer Index Composite-26 EPIC, confidence in self-management) and secondary outcomes between groups using intent-to-treat analyses. We compared domain-specific changes in symptom burden from baseline to 5 and 12 months among the intervention group according to the primary symptom focus area (urinary, bowel, sexual, general) of participants. RESULTS Most of the prostate cancer survivors in this study were married (54.3%), were white (69.2%), were retired (62.4%), and underwent radiation therapy (56.7% v 46.2% who underwent surgery), and the mean age was 67 years. There were no baseline differences in urinary, bowel, sexual, or hormonal domain EPIC scores across groups. We observed higher EPIC scores in the intervention arm in all domain areas at 5 months, though differences were not statistically significant. No differences were found in secondary outcomes; however, coping appraisal was higher (2.8 v 2.6; P = .02) in intervention-arm patients at 5 months. In subgroup analyses, intervention participants reported improvement from baseline at 5 and 12 months in their symptom focus area domains. CONCLUSION This intervention was well received among veterans who were long-term survivors of prostate cancer. Although overall outcome differences were not observed across groups, the intervention tailored to symptom area of choice may hold promise to improve associated burden.
Skolarus et al. (Fri,) conducted a rct in Prostate cancer survivorship with symptom burden (n=556). Building Your New Normal (automated telephone assessments plus tailored newsletters) vs. Enhanced usual care (one nontailored newsletter) was evaluated on EPIC Urinary incontinence score at 5 months (Adjusted mean difference 2.2, 95% CI -0.5 to 4.9, p=0.11). A personally tailored, automated telephone symptom management intervention did not significantly improve overall symptom burden or confidence in symptom self-management compared to a nontailored newsletter among long-term prostate cancer survivors.