BMT-CARE App: A Randomized Controlled Trial of a Psychosocial Digital Application for Caregivers of Patients Undergoing Hematopoietic Stem-Cell Transplantation.
Jamie M Jacobs, Lara Traeger, Madison Freese, Anna Barata, Richard Newcomb, Dustin Rabideau, Nora Horick, Zachariah DeFilipp, Yi-Bin Chen, Tamryn Gray, Julia Pepper, Ella Caruso, Hermioni L Amonoo, Stephanie J Lee, Joseph A Greer, Jennifer S Temel, Areej El-Jawahri
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引用次数: 0
Abstract
Purpose: Family and friend caregivers of patients undergoing hematopoietic stem-cell transplantation (HSCT) struggle with immense caregiving burden, leading to substantial quality of life (QOL) impairments and psychological distress. Yet, interventions to address caregivers' needs are limited.
Materials and methods: We conducted a randomized controlled trial of a psychosocial digital application (BMT-CARE App) versus usual care for adult caregivers of patients with hematologic malignancies undergoing HSCT. The BMT-CARE App included five modules combining psychoeducation and evidence-based behavior change strategies. Participants completed self-report measures at baseline and day 60 post-HSCT. The primary end point was QOL at day 60 assessed by the CareGiver Oncology QOL (CarGOQOL) measure. We also assessed caregiving burden (Caregiver Reaction Assessment), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), and post-traumatic stress disorder (PTSD) symptoms (PTSD Checklist [PCL-5]). We used analysis of covariance adjusting for baseline scores to assess the effect of the intervention on study outcomes.
Results: Between February 2023 and July 2024, we enrolled 125 of 174 approached caregivers (71.8%). Participants assigned to the BMT-CARE App used the app for a median of 146.9 minutes (range, 0-384.8). At day 60, BMT-CARE App caregivers reported clinically and significantly better QOL than those assigned to usual care (adjusted means = 76.3 v 69.9, P = .006). BMT-CARE App participants also reported significantly lower caregiving burden (11.2 v 12.3, P = .023), depression (3.8 v 5.6, P = .002), and PTSD symptoms (26.1 v 31.3, P = .012). The groups did not differ significantly in anxiety symptoms at day 60.
Conclusion: The BMT-CARE App led to significantly improved QOL, caregiving burden, depression, and PTSD symptoms among HSCT caregivers. This intervention should be tested in a multicenter study with a diverse HSCT caregiver population to determine generalizability and scalability.
目的：接受造血干细胞移植（HSCT）患者的家人和朋友照顾者与巨大的照顾负担作斗争，导致严重的生活质量（QOL）损害和心理困扰。然而，满足照顾者需求的干预措施是有限的。材料和方法：我们进行了一项随机对照试验，比较心理社会数字应用程序（BMT-CARE应用程序）与成人护理人员对接受造血干细胞移植的恶性血液肿瘤患者的常规护理。BMT-CARE App包括五个模块，结合了心理教育和基于证据的行为改变策略。参与者在基线和hsct后第60天完成自我报告测量。主要终点是第60天的生活质量，通过护理肿瘤学生活质量（CarGOQOL）测量来评估。我们还评估了照顾负担（看护者反应评估）、焦虑和抑郁症状（医院焦虑和抑郁量表）以及创伤后应激障碍（PTSD）症状（PTSD检查表[PCL-5]）。我们使用协方差分析调整基线得分来评估干预对研究结果的影响。结果：在2023年2月至2024年7月期间，我们招募了174名接近护理人员中的125名（71.8%）。分配到BMT-CARE应用程序的参与者使用该应用程序的中位数为146.9分钟（范围0-384.8分钟）。在第60天，BMT-CARE App护理人员报告的临床生活质量明显优于常规护理组（调整平均值= 76.3 v 69.9, P = 0.006）。BMT-CARE应用程序参与者还报告了显著降低的护理负担（11.2 v 12.3, P = 0.023）、抑郁（3.8 v 5.6, P = 0.002）和PTSD症状（26.1 v 31.3, P = 0.012）。两组在第60天的焦虑症状上没有显著差异。结论：BMT-CARE应用程序显著改善了HSCT照顾者的生活质量、照顾负担、抑郁和创伤后应激障碍症状。这种干预措施应该在多中心研究中进行测试，包括不同的HSCT护理人群，以确定其普遍性和可扩展性。
期刊介绍：
The Journal of Clinical Oncology serves its readers as the single most credible, authoritative resource for disseminating significant clinical oncology research. In print and in electronic format, JCO strives to publish the highest quality articles dedicated to clinical research. Original Reports remain the focus of JCO, but this scientific communication is enhanced by appropriately selected Editorials, Commentaries, Reviews, and other work that relate to the care of patients with cancer.
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