Palliative care aims to provide relief of pain and other patient symptoms, such as fatigue, dyspnea, constipation, anxiety, and depression, in order to improve quality of life. Patients in isolated rural settings often lack easy access to palliative care and other specialist services. Yet rural residents are more likely than their urban counterparts to be older;be in poorer overall health;suffer from more chronic or serious illnesses and disabilities;be uninsured or underinsured;and live in poverty. Telehealth is an emerging method of health care delivery that has been found useful and effective in many clinical settings and specialties. Telehealth technologies can bridge geographic distance and increase access to specialist care in rural settings. We propose a cluster randomized clinical trial design to test the effects of a telehealth-enhanced palliative care symptom-management program for 288 cancer patients and 96 providers in rural health care settings. The proposed program will provide services to both patients and providers: Patients will conduct self-assessments and report pain and other symptoms via telehealth. Health care providers will receive telehealth-delivered case consultations that will include case management, evidence-based practice resources, and peer support. Providers and their patients will be randomly assigned to intervention groups, which receive the telehealth- enhanced palliative care symptom-management intervention, or to control groups. Our primary aim is to compare patient self-reports of symptoms and quality of life in the intervention and control groups over 2 months.
Aim 2 is to examine, in the intervention and control groups over 2 months, providers'knowledge and attitudes regarding symptoms and perceived competence in treating symptoms.
Aim 3 is to evaluate the cost- effectiveness of the telehealth intervention. We will use mixed effects models with patients nested within providers to evaluate the effect of the intervention on study outcomes. Findings from this study will be instrumental in advancing telehealth and improving symptom management and palliative care among underserved rural populations.
Rural patients face many health disparities, including challenges in obtaining palliative care for relief of pain and other distressing symptoms. This study will evaluate the effectiveness of a telehealth-enhanced palliative care symptom-management intervention for rural cancer patients and their health care providers. The findings of this study will be instrumental in enhancing symptom management and palliative care, which will have applicability to delivery of other specialist care among underserved rural populations.
|Eaton, Linda H; Langford, Dale J; Meins, Alexa R et al. (2018) Use of Self-management Interventions for Chronic Pain Management: A Comparison between Rural and Nonrural Residents. Pain Manag Nurs 19:8-13|
|Cook, Wendy A; Morrison, Megan L; Eaton, Linda H et al. (2017) Quantity and Quality of Economic Evaluations in U.S. Nursing Research, 1997-2015: A Systematic Review. Nurs Res 66:28-39|
|Flynn, Diane M; Eaton, Linda H; McQuinn, Honor et al. (2017) TelePain: Primary Care Chronic Pain Management through Weekly Didactic and Case-based Telementoring. Contemp Clin Trials Commun 8:162-166|
|Eaton, Linda H; Meins, Alexa R; Zeliadt, Steven B et al. (2017) Using a mixed methods approach to explore factors associated with evidence-based cancer pain management practice among nurses. Appl Nurs Res 37:55-60|
|Eaton, Linda H; Meins, Alexa R; Mitchell, Pamela H et al. (2015) Evidence-based practice beliefs and behaviors of nurses providing cancer pain management: a mixed-methods approach. Oncol Nurs Forum 42:165-73|
|Song, Wenjia; Eaton, Linda H; Gordon, Debra B et al. (2015) Evaluation of Evidence-based Nursing Pain Management Practice. Pain Manag Nurs 16:456-63|
|Theodore, Brian R; Whittington, Jan; Towle, Cara et al. (2015) Transaction cost analysis of in-clinic versus telehealth consultations for chronic pain: preliminary evidence for rapid and affordable access to interdisciplinary collaborative consultation. Pain Med 16:1045-56|
|Meins, Alexa R; Doorenbos, Ardith Z; Eaton, Linda et al. (2015) TelePain: A Community of Practice for Pain Management. J Pain Relief 4:|
|Eaton, Linda H; Gordon, Debra B; Wyant, Sheryl et al. (2014) Development and implementation of a telehealth-enhanced intervention for pain and symptom management. Contemp Clin Trials 38:213-20|
|Schorn, Melissa M; Doorenbos, Ardith Z; Gordon, Debra et al. (2014) Survey of Primary-Care Providers on Perceived Benefits of and Barriers to PainTracker. J Nurse Pract 10:781-786|
Showing the most recent 10 out of 19 publications