Usability of PCforMe in patients with advanced cancer referred to outpatient palliative care : results of a randomized, active-controlled pilot trial

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KAMAL, Arif H. | WOLF, Steven | NICOLLA, Jonathan M. | FRIEDMAN, Fred | XUAN, Mengdi | BENNETT, Antonia V. | SAMSA, Greg

CONTEXT: Low utilization of palliative care services warrant the development and testing of new solutions to educate and engage patients around the benefits of palliative care. OBJECTIVES: We sought out to develop and test a novel, mobile health solution to prepare patients for an upcoming outpatient palliative care appointment. METHODS: After developing a web-based tool called PCforMe (Palliative Care for Me), we conducted a randomized, active-controlled, trial of PCforMe. The primary outcome was the score on the System Usability Scale (SUS). Secondary outcomes were patient self-efficacy (measured by PEPPI) and change in knowledge (measured by a questionnaire). We compared PCforMe to three common online resources for patients seeking information about specialty palliative care. RESULTS: 80 patients were randomized. There were no significant demographic differences. Mean SUS score for PCforMe was 78.2, significantly above the normative average SUS score of 68 (p-value<0.0001). Mean change in PEPPI score was -2.2 for PCforMe vs -1.7 for control group (p-value=0.72). Preparedness for an upcoming palliative care visit increased 50% in the intervention group versus 13.3% in the control group. Difference in the number of patients with improved knowledge regarding palliative care approached significance (p=0.06). Lastly, we found the no-show rate lower during Q1 2017 (during trial) versus Q1 2016 (before trial), at 11.7% versus 21% (p<0.05). Comparing the full calendar year 2016 versus 2017, we did not find a statistical difference (CY 2016 of 18.8% versus 15% in CY 2017; p=0.22). CONCLUSION: PCforMe is a usable mobile health tool to educate and prepare patients for an upcoming palliative care appointment. Further research is needed to test effectiveness.

http://dx.doi.org/10.1016/j.jpainsymman.2019.05.007

Voir la revue «JOURNAL OF PAIN AND SYMPTOM MANAGEMENT»

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