One day at a time: Improving the patient experience during and after intensive chemotherapy for younger and older AML patients

Ghodraty-Jabloo, Vida; Alibhai, Shabbir M.H.; Breunis, Henriette; Puts, Martine

doi:10.1016/j.leukres.2014.11.028

Cited by 15 publications

(22 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, IC is burdened with severe toxicities and distress [4][5][6]. In our recent study in patients with AML, we showed that fatigue, weakness, dizziness, and chemobrain were the most bothersome physical symptoms just after completing IC [7]. Additionally, our analysis revealed that participants were affected with an overwhelming sense of loss, fear, and uncertainty in the early phase of IC [7].…”

Section: Introductionmentioning

confidence: 61%

“…Receiving a diagnosis of AML and undergoing chemotherapy are traumatic experiences burdened with enormous physical and psychological distress [4,5,7]. Effective coping strategies are required to adjust to life with AML [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, their psychosocial well-being was impaired by perceived changes in their ability to initiate and maintain relationships and resume former activities. The negative effect of perceived loss of functional and mental abilities on work and social reintegration was also found in leukemia survivors 6 months after diagnosis [7]. Therefore, incorporating psychosocial interventions into survivorship care plans may be warranted to help AML survivors adjust to their limitations and new identity as leukemia survivors.…”

Section: Discussionmentioning

confidence: 99%

“…In our recent study in patients with AML, we showed that fatigue, weakness, dizziness, and chemobrain were the most bothersome physical symptoms just after completing IC [7]. Additionally, our analysis revealed that participants were affected with an overwhelming sense of loss, fear, and uncertainty in the early phase of IC [7]. Likewise, two recent cross-sectional studies on newly diagnosed AML patients receiving IC and one longitudinal study of AML patients undergoing prolonged chemotherapy documented a high prevalence of traumatic stress symptoms, intense worrying and sadness, uncertainty about durable remission, and fear of cancer recurrence as serious threat to psychological well-being [4,5,8].…”

Section: Introductionmentioning

confidence: 91%

“…Building upon our previous qualitative study on QOL and physical function of leukemia survivors 6 months after diagnosis [7], the present study explored survivorship issues 12 months after diagnosis. This time point was chosen because by 12 months, many patients have completed their chemotherapy and are reintegrating into society [22].…”

Section: Study Design and Samplementioning

confidence: 99%

See 4 more Smart Citations

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML)

Ghodraty-Jabloo

Alibhai

Breunis

et al. 2015

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Section: Study Design and Samplementioning

confidence: 99%

See 3 more Smart Citations

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML)

Ghodraty-Jabloo

Alibhai

Breunis

et al. 2015

Support Care Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

Effectiveness of Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia

et al. 2021

View full text Add to dashboard Cite

IMPORTANCEPatients with acute myeloid leukemia (AML) receiving intensive chemotherapy experience substantial decline in their quality of life (QOL) and mood during their hospitalization for induction chemotherapy and often receive aggressive care at the end of life (EOL). However, the role of specialty palliative care for improving the QOL and care for this population is currently unknown.OBJECTIVE To assess the effect of integrated palliative and oncology care (IPC) on patient-reported and EOL outcomes in patients with AML. DESIGN, SETTING, AND PARTICIPANTSWe conducted a multisite randomized clinical trial of IPC (n = 86) vs usual care (UC) (n = 74) for patients with AML undergoing intensive chemotherapy. Data were collected from January 2017 through July 2019 at 4 tertiary care academic hospitals in the United States.INTERVENTIONS Patients assigned to IPC were seen by palliative care clinicians at least twice per week during their initial and subsequent hospitalizations. MAIN OUTCOMES AND MEASURESPatients completed the 44-item Functional Assessment of Cancer Therapy-Leukemia scale (score range, 0-176) to assess QOL; the 14-item Hospital Anxiety and Depression Scale (HADS), with subscales assessing symptoms of anxiety and depression (score range, 0-21); and the PTSD Checklist-Civilian version to assess posttraumatic stress disorder (PTSD) symptoms (score range, 17-85) at baseline and weeks 2, 4, 12, and 24. The primary end point was QOL at week 2. We used analysis of covariance adjusting and mixed linear effect models to evaluate patient-reported outcomes. We used Fisher exact test to compare patient-reported discussion of EOL care preferences and receipt of chemotherapy in the last 30 days of life. RESULTSOf 235 eligible patients, 160 (68.1%) were enrolled; of the 160 participants, the median (range) age was 64.4 (19.7-80.1) years, and 64 (40.0%) were women. Compared with those receiving UC, IPC participants reported better QOL (adjusted mean score, 107.59 vs 116.45; P = .04), and lower depression (adjusted mean score, 7.20 vs 5.68; P = .02), anxiety (adjusted mean score, 5.94 vs 4.53; P = .02), and PTSD symptoms (adjusted mean score, 31.69 vs 27.79; P = .01) at week 2. Intervention effects were sustained to week 24 for QOL (β, 2.35; 95% CI, 0.02-4.68; P = .048), depression (β, −0.42; 95% CI, −0.82 to −0.02; P = .04), anxiety (β, −0.38; 95% CI, −0.75 to −0.01; P = .04), and PTSD symptoms (β, −1.43; 95% CI, −2.34 to −0.54; P = .002). Among patients who died, those receiving IPC were more likely than those receiving UC to report discussing EOL care preferences (21 of 28 [75.0%] vs 12 of 30 [40.0%]; P = .01) and less likely to receive chemotherapy near EOL (15 of 43 [34.9%] vs 27 of 41 [65.9%]; P = .01). CONCLUSIONS AND RELEVANCEIn this randomized clinical trial of patients with AML, IPC led to substantial improvements in QOL, psychological distress, and EOL care. Palliative care should be considered a new standard of care for patients with AML.

show abstract

Psychological mobile app for patients with acute myeloid leukemia: A pilot randomized clinical trial

El‐Jawahri

Luskin

Greer

et al. 2023

Cancer

View full text Add to dashboard Cite

Background Patients with acute myeloid leukemia (AML) experience a substantial decline in quality of life (QoL) and mood during their hospitalization for intensive chemotherapy, yet few interventions have been developed to enhance patient‐reported outcomes during treatment. Methods We conducted a pilot randomized trial (ClinicalTrials.gov identifier NCT03372291) of DREAMLAND, a psychological mobile application for patients with a new diagnosis of AML who are receiving intensive chemotherapy. Patients were randomly assigned to DREAMLAND or usual care. DREAMLAND included four required modules focused on: (1) supportive psychotherapy to help patients deal with the initial shock of diagnosis, (2) psychoeducation to manage illness expectations, (3) psychosocial skill‐building to promote effective coping, and (4) self‐care. The primary end point was feasibility, which was defined as ≥60% of eligible patients enrolling and 60% of those enrolled completing ≥60% of the required modules. We assessed patient QoL (the Functional Assessment of Cancer Therapy–Leukemia), psychological distress (the Hospital Anxiety and Depression Scale and the Patient Health Questionnaire‐9), symptom burden (the Edmonton Symptom Assessment Scale), and self‐efficacy (the Cancer Self‐Efficacy Scale) at baseline and at day 20 after postchemotherapy. Results We enrolled 60 of 90 eligible patients (66.7%), and 62.1% completed ≥75% of the intervention modules. At day 20 after chemotherapy, patients who were randomized to DREAMLAND reported improved QoL scores (132.06 vs. 110.72; p =.001), lower anxiety symptoms (3.54 vs. 5.64; p = .010) and depression symptoms (Hospital Anxiety and Depression Scale: 4.76 vs. 6.29; p = .121; Patient Health Questionnaire‐9: 4.62 vs. 8.35; p < .001), and improved symptom burden (24.89 vs. 40.60; p = .007) and self‐efficacy (151.84 vs. 135.43; p = .004) compared with the usual care group. Conclusions A psychological mobile application for patients with newly diagnosed AML is feasible to integrate during hospitalization for intensive chemotherapy and may improve QoL, mood, symptom burden, and self‐efficacy.

show abstract

One day at a time: Improving the patient experience during and after intensive chemotherapy for younger and older AML patients

Cited by 15 publications

References 33 publications

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML)

Keep your mind off negative things: coping with long-term effects of acute myeloid leukemia (AML)

Effectiveness of Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia

Psychological mobile app for patients with acute myeloid leukemia: A pilot randomized clinical trial

Contact Info

Product

Resources

About