A web-based program called “WRITE Symptoms” can improve symptom control for patients with recurrent ovarian cancer, according to a study published in the Journal of Clinical Oncology.
Patients who completed the program under their own direction or under nurse direction had better symptom control than did patients treated with enhanced usual care.
The study (ClinicalTrials.gov Identifier: NCT00958698) enrolled 497 patients with recurrent or persistent ovarian, fallopian, or primary peritoneal cancer who had 3 or more symptoms.
At study entry, patients reported a mean 14.2 (standard deviation, 4.9) concurrent symptoms, most commonly fatigue (52.1%), constipation (25.2%), and peripheral neuropathy (24.9%). Most patients (85%) were receiving chemotherapy, and 58.8% had received 3 or more previous chemotherapy regimens.
About the Interventions
Patients were randomly assigned to receive enhanced usual care alone (165 patients) or in combination with a nurse-directed web-based intervention (Nurse-WRITE; 166 patients) or a self-directed web-based intervention (SD-WRITE; 166 patients).
Enhanced usual care consisted of symptom monitoring and access to curated information on the WRITE Symptoms website (not the entire program). WRITE Symptoms is a program designed to help patients with recurrent ovarian cancer gain better control over their symptoms.
In the SD-WRITE group, an interactive computer module guided each patient through the WRITE Symptoms intervention over 6-8 weeks to develop a tailored symptom care plan. This was followed by a 2-week review and revision for each patient’s 3 target symptoms.
In the Nurse-WRITE group, patients received access to a password-protected private message board. Using this board, nurses led each patient through the WRITE Symptoms intervention and developed individualized symptom care plans. This was followed by a 2-week review and revision for each patient’s 3 target symptoms.
Results by Intervention
Outcomes were evaluated at 8 weeks and 12 weeks after the baseline assessment.
Approximately 69% of patients in the Nurse-WRITE group and 77% in the SD-WRITE group completed a symptom care plan for at least 1 target symptom.
Regarding target symptom controllability, there was a significant group-by-time interaction (P <.001) in which the Nurse-WRITE and SD-WRITE groups were found superior to the enhanced usual care group.
There was a significant improvement in symptom controllability scores in the Nurse- and SD-WRITE groups from baseline to 8 weeks (P <.001 for both) and from baseline to 12 weeks (Nurse-WRITE, P <.001; SD-WRITE, P =.002).
In contrast, patients receiving enhanced usual care did not show an improvement in symptom controllability over time.
Regarding target symptom burden, the scores significantly improved across all 3 groups from baseline to 8 weeks (P <.001) and from baseline to 12 weeks (P <.001). No group-by-time interactions (P =.18) or group main effects (P =.24) were reported.
With regard to quality of life (QOL), a significant time effect was observed, with improvement in scores from baseline to 8 weeks (P <.001) and from baseline to 12 weeks (P <.001) seen in all 3 groups. No significant group-by-time interactions (P =.83) or group main effects (P =.24) were reported for QOL.
“The web-based WRITE Symptoms intervention, regardless of delivery method, enhanced women’s sense of control over their three target symptoms,” the researchers wrote. “The computer-mediated SD-WRITE is an efficient and scalable intervention with potential for implementation in clinical settings.”
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Reference Donovan HS, Sereika SM, Wenzel LB, et al. Effects of the WRITE symptoms interventions on symptoms and quality of life among patients with recurrent ovarian cancers: An NRG Oncology/GOG study (GOG-0259). J Clin Oncol. Published online February 7, 2022. doi:10.1200/JCO.21.00656