Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?

Our plain-English summary of Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?, by C.L. Paul, A.W. Boyes, L. O'Brien, et al (JMIR Research Protocols, 2016).

The study

• Authors: C.L. Paul, A.W. Boyes, L. O'Brien, A.L. Baker, F.A. Henskens, I. Roos, T. Clinton-McHarg, D. Bellamy, G. Colburn, S. Rose, M.E. Cox, E.A. Fradgley, H. Baird, D. Barker
• Journal: JMIR Research Protocols
• Published: 2016;5(4):e202
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Community-based services such as telephone support lines can provide valuable informational, emotional, and practical support for cancer patients via telephone- or Web-based (live chat or email) platforms. However, very little rigorous research has examined the efficacy of such services in improving patient outcomes.

Objective: This study will determine whether: proactive telephone or Web-delivered support produces outcomes superior to printed information; and Web-delivered support produces outcomes comparable to telephone support.

Methods: A consecutive sample of 501 lung cancer outpatients will be recruited from 50 Australian health services to participate in a patient-randomized controlled trial (RCT). Eligible individuals must: be 18 years or older; have received a lung cancer diagnosis (including mesothelioma) within the previous 4 months; have an approximate life expectancy of at least 6 months; and have Internet access. Participants will be randomly allocated to receive: (1) an information booklet, (2) proactive telephone support, or (3) proactive Web support, chat, and/or email. The primary patient outcomes will be measured by the General Health Questionnaire (GHQ-12) and Health Education and Impact Questionnaire (heiQ) at 3 and 6 months post recruitment. The acceptability of proactive recruitment strategies will also be assessed.

Results: It is hypothesized that participants receiving telephone or Web support will report reduced distress (GHQ-12 scores that are 0.3 standard deviations (SD) lower) and greater self-efficacy (heiQ scores that are 0.3 SDs higher) than participants receiving booklets. Individuals receiving Web support will report heiQ scores within 0.29 SDs of individuals receiving telephone support.

Conclusions: If proven effective, electronic approaches such as live-chat and email have the potential to increase the accessibility and continuity of supportive care delivered by community-based services. This evidence may also inform the redesigning of helpline-style services to be effective and responsive to patient needs.

In plain English

This article was a protocol. It described a planned randomized controlled trial in Australia and reported no results. The authors planned to recruit 501 adult outpatients diagnosed within the previous 4 months with any type of lung cancer, including mesothelioma, who had a life expectancy of at least 6 months and Internet access. Participants were to be randomly assigned to one of three groups: a mailed information booklet, proactive telephone calls, or proactive email and live-chat support. Both support options were to come from the Cancer Council New South Wales Cancer Information and Support service. The main outcomes were distress (GHQ-12) and self-management and health-literacy (heiQ) scores at 3 and 6 months. The authors hypothesized that at 6 months both support groups would have GHQ-12 scores 0.3 of a standard deviation lower and heiQ scores 0.3 of a standard deviation higher than the booklet group. They also hypothesized that the Web group's heiQ scores would be within 0.29 of a standard deviation of the telephone group's. The study did not examine asbestos exposure. Recruitment was underway and was to conclude in September 2017.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Protocol for a planned multisite randomized controlled trial with three arms (no results reported)
• Who was studied: Planned 501 adult lung cancer outpatients, including people with mesothelioma, diagnosed less than 4 months earlier, with approximate life expectancy of at least 6 months and Internet access, recruited from 50 Australian health services
• Exposure: Not asbestos. The study compared three forms of information and support: a printed booklet (control), proactive telephone support, and proactive Web support (email and live chat) from the Cancer Council New South Wales Cancer Information and Support service
• The authors' conclusion: The authors stated that combining active recruitment with Web-based options could increase the accessibility and continuity of supportive care, if the trial outcome is positive
• Limitations the authors state:
  • Patients and support consultants could not be blinded to which group a participant was in
  • Participants in the booklet group might contact the support service on their own, which could contaminate the comparison; the authors planned to check for this
  • Contact with the same consultant each time may not always occur

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Life Expectancy.

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