Symptoms are a major problem across all phases of the cancer experience. Despite the presence of effective therapies for pain and other symptoms including depression, anxiety, constipation, etc., survey data demonstrates a gap between routine cancer treatment and evidence based symptom management that leaves many patients'symptoms unrecognized and under-treated. I am applying for a K07 Career Award in order to master clinical trial and symptom assessment methodology in palliative and supportive oncology in order to discover new and best practices in the field. In line with these goals, I propose developing a computer-based system that will both acquire research-quality data from patients and support oncologists in managing their patients'symptoms. The intervention will combine systematic computer-aided symptom assessment and computer-generated printed symptom summaries for patients and oncologists accompanied by relevant recommendations from clinical practice guidelines. Extensive user testing will ensure that the summaries are maximally useful and easy-to-use.
The specific aims for this proposal include determining whether oncologists using this system change their symptom assessment and symptom management practice patterns and determining whether intervention group patients have less symptom burden. I propose to pilot test the intervention in a clinical trial with a sequential group design involving 100 patients with androgen independent prostate cancer who are receiving chemotherapy. The main outcomes will be physicians'prescribing patterns for analgesic, antidepressant, and laxative medications, the number of symptoms documented in 'adverse events'logs and patients'charts, and patients'QLQ-C30 scores for pain, fatigue and global quality of life. The significance of the proposed research is that it will yield an integrated symptom assessment and clinical decision support tool and generate the validation and preliminary data necessary to justify a test of the computer-based system in a multi-center randomized controlled trial.
| Albrecht, Jennifer S; Gruber-Baldini, Ann L; Fromme, Erik K et al. (2013) Quality of hospice care for individuals with dementia. J Am Geriatr Soc 61:1060-5 |
| Rosenberg, Joseph H; Albrecht, Jennifer S; Fromme, Erik K et al. (2013) Antimicrobial use for symptom management in patients receiving hospice and palliative care: a systematic review. J Palliat Med 16:1568-74 |
| Albrecht, Jennifer S; McGregor, Jessina C; Fromme, Erik K et al. (2013) A nationwide analysis of antibiotic use in hospice care in the final week of life. J Pain Symptom Manage 46:483-90 |
| White, Jocelyn; Fromme, Erik K (2013) ""In the beginning..."": tools for talking about resuscitation and goals of care early in the admission. Am J Hosp Palliat Care 30:676-82 |
| Samuelson, Bethany T; Fromme, Erik K; Thomas Jr, Charles R (2012) Changes in spirituality and quality of life in patients undergoing radiation therapy. Am J Hosp Palliat Care 29:449-54 |
| Fromme, Erik K; Zive, Dana; Schmidt, Terri A et al. (2012) POLST Registry do-not-resuscitate orders and other patient treatment preferences. JAMA 307:34-5 |
| Fromme, Erik K; Stewart, Tanya Lugliani; Jeppesen, Margaret et al. (2011) Adverse experiences with implantable defibrillators in Oregon hospices. Am J Hosp Palliat Care 28:304-9 |
| Fromme, Erik K; Kenworthy-Heinige, Tawni; Hribar, Michelle (2011) Developing an easy-to-use tablet computer application for assessing patient-reported outcomes in patients with cancer. Support Care Cancer 19:815-22 |
| Benzar, Emma; Hansen, Lissi; Kneitel, Anna W et al. (2011) Discharge planning for palliative care patients: a qualitative analysis. J Palliat Med 14:65-9 |
| Fromme, Erik K; Smith, Mary Denise; Bascom, Paul B et al. (2010) Incorporating routine survival prediction in a U.S. hospital-based palliative care service. J Palliat Med 13:1439-44 |
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