Effect of the Decision Support System Developed for Symptom Self-Management on Symptom Management, Quality of Life and Unplanned Hospital Admissions in Patients With Non-Hodgkin's Lymphoma: A Randomized Active-Controlled Trial

Abstract

Objectives

The development of web-based decision support systems that can support the management of symptoms at home may improve patients' quality of life (QoL) and patient outcomes. This study aimed to develop a decision support system for symptom self-management (Lymphoma Symptom CARE [LympCARE]) in patients with NHL and to evaluate the effect of the application on symptom management, QoL, and unplanned hospital admissions.

Methods

A 2-group pre- and post-test randomized active-controlled trial was conducted in 56 patients with NHL from a university hospital in Turkey. A mobile-friendly decision support system (DSS) (LympCARE) was developed for patients with NHL. The patients in the intervention group evaluated symptom severity and applied self-management strategies with the DSS developed for symptom self-management on the 3^rd, 7^th, and 10^th days after the 3^rd, 4^th, and 5^th cycles of chemotherapy via LympCARE, respectively. Multiple linear regression analysis was used to assess the effects of within-group, time-dependent changes.

Results

In the LympCARE group, 18% were male and 85.7% were ≤60 years old, and in the active control group, 18% were male and 64.3% were ≤60 years old. LympCARE expert opinions showed a high level of agreement. The difference between symptom management and QoL post-test mean scores of the LympCARE and active control groups were statistically significant. The number of unplanned hospital admissions decreased in both groups. In the LympCARE group, 89.9% and 78% of the active control group found the mobile-compatible DSS effective, respectively.

Conclusions

The developed symptom self-management DSS increased patients' symptom management and QoL levels and decreased the level of unplanned hospital admission.

Implications for nursing practice

By demonstrating the efficacy of DSS in significantly reducing pre- and post-intervention symptom management, QoL, and unplanned hospital admissions, the study offers an accessible, nonpharmacological, and engaging intervention that can be seamlessly integrated into existing healthcare practices.