We propose to evaluate Cancer CareLink Symptom Manager, an Internet-based system designed to support the care of patients with cancer-related symptoms that are typically difficult to manage. We will focus on three cancer-related symptoms: pain, fatigue, and emotional distress. These three symptoms were selected based on their prevalence among cancer patients, the association between these symptoms and reduced quality of life, and the availability of structured treatment guidelines for their clinical management. In our Phase I research we identified clinician and patient requirements for Cancer CareLink. We determined that patients and clinicians would be likely to use the Internet-based support system if it were shown to improve care. As a result of our Phase I efforts we believe Cancer CareLink will provide measurable benefits to patients and the providers involved in their care. The primary objectives of this Phase II study will be: To compare utilization, comprehension, and satisfaction with educational materials provided in the Cancer Care Link condition to those receiving usual care. To compare perceived self-efficacy in self-management of cancer-related fatigue, pain, and distress in the Cancer Care Link condition to those receiving usual care; To compare characteristics of medical care in the Cancer Care Link condition to those receiving usual care. Patients attending outpatient oncology clinics of the Robert H. Lurie Comprehensive Cancer Center will be recruited. Consenting patients will be randomly assigned to receive Cancer Care Link (N=50) or to receive usual care (N=50) for three months. Patients in both groups will receive (1) an in-depth assessment at study enrollment, (2)educational materials, (3)weekly symptom assessments, and (4)an in-depth assessment at study completion. Cancer Care Link patients and their clinical providers will also receive (5)visual summaries of weekly symptom ratings, and (6) treatment recommendations. Usage trends and usability evaluation of Cancer CareLink will be conducted. Functional usage distribution, average length of time spent on a function, average completion time of individual tasks and error rates in performing tasks will be evaluated. We anticipate that Cancer CareLink will serve as a model for enhancing care processes and patient outcomes.
