Implementation of telehealth and health technology to improve patient outcomes

Division Of Basic Sciences - Nci

Investigators

Linked publications & trials

Abstract

We have recently initiated three clinical trials using telehealth and health related technologies to improve patient experience for those with primary brain tumors (PBTs) or primary central nervous system tumors (PCNSTs): The first trial will use describe sleep disturbances and circadian disruption in people with PBT using Fitbits to learn more about sleep disruptions caused by tumors. Participants in this trial will receive a Fitbit, which they will wear for one month to track sleep, heart rate, and activity, they will keep a sleep diary for one week, and complete 4 surveys with questions about the patient's quality of sleep, their ability to fall asleep and stay asleep, how the quality of their sleep affects their daily activities, and their sleep hygiene and preferences. We will assess the feasibility of using smart wearable devices to measure the impact of oncologic therapy on sleep and circadian rhythms in the PBT population. We will also assess if reported quality of sleep collected with the PROMIS Sleep Indices are comparable between clinical evaluation and collection at-home, if patient chronotype, as measured by the Morningness-Eveningness Questionnaire (MEQ), are more pronounced in individuals with circadian disruption or sleep disturbances as measured by smart wearables, or if circadian rhythm variables (Amplitude and Phase onset/offset) are dampened or phase shifted in patients with moderate to severe levels of sleep disturbances (as measured by the MDASI-BT, score of =5). This trial has begun enrolling participants by invitation. The second trial will assess whether a type of therapy called CALM can help patients with PCNST manage distress symptoms and the emotional challenges experienced with a tumor diagnosis. Participants will fill out 7 electronic surveys asking about physical and emotional symptoms, depression, feelings about death and dying, feelings about close relationships, and general well-being. Participants will be assigned to a CALM therapist and will have 3 to 6 individual therapy sessions in 6 months. To assess the effects of the CALM intervention in reduction of depressive symptoms we will compare PROMIS-Depression scale results in PCNST participants from baseline to 6 months. We will also assess the effects of CALM intervention on death anxiety at both 3 and 6 months using the Death and Dying Distress Scale (DADDS), and the feasibility of implementing CALM remotely in a PCNST population. This trial has begun enrolling participants by invitation. The third trial will assess if virtual reality (VR) technology can help reduce stress and improve mood in people with PBTs. Participants will receive a VR headset by mail, which they will use to view computer-generated environments, and they will complete questionnaires at 4 timepoints during the study. At the end of the study we will assess the number of participants who completed the study, the effects of a VR intervention on self-reported mood disturbance (as measured by PROMIS -Anxiety PROMIS -Depression Short Forms) and symptom burden and interference (as measured by the MD Anderson Symptom Inventory Brain Tumor [MDASI-BT]), if the effects VR has on distress and anxiety are more pronounced in those with high distress (based on DT cut-off score of greater than or equal to 5) compared those with to low distress (based on DT scores of 0 4) Measurement of Distress, the effects of a VR intervention on self-reported acute and subacute distress (as measured by the NCCN Distress Thermometer [DT]) and anxiety (as measured by the State Anxiety Inventory [STAI-6]) in PBT patients, and if the effects VR has on distress and anxiety are more pronounced in those individuals not on systemic corticosteroids (CS) compared to those who are not. This trial has begun recruiting participants.