Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting

Jennifer L. Steel, David A. Geller, Kevin H. Kim, Lisa H. Butterfield, Michael Spring, Jonathan Grady, Weiing Sun, Wallis Marsh, Michael Antoni, Mary Amanda Dew, Vicki Helgeson, Richard Schulz, Allan Tsung

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


BACKGROUND The aim of this study was to examine the efficacy of a collaborative care intervention in reducing depression, pain, and fatigue and improve quality of life. METHODS A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included the following: 1) a web site with written and audiovisual self-management strategies, a bulletin board, and other resources; 2) visits with a care coordinator during a physician's appointment every 2 months; and 3) telephone follow-up every 2 weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health-related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, and IL-8 levels, Natural Killer (NK) cell numbers, and caregiver stress and depression. RESULTS At the baseline, 51% of the patients reported 1 or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms and were randomized to the intervention, reductions in depression (Cohen's d = 0.71), pain (Cohen's d = 0.62), and fatigue (Cohen's d = 0.26) and improvements in quality of life (Cohen's d = 0.99) were observed when compared to those in the enhanced usual car arm at 6 months. Reductions in IL-6 (φ = 0.18), IL-1β (φ = 0.35), IL-1α (φ = 0.19), and IL-8 (φ = 0.15) and increases in NK cell numbers (φ = 0.23) were observed in comparison with enhanced usual care arm at 6 months. Reductions in caregiver stress (Cohen's d = 0.75) and depression (Cohen's d = 0.37) were observed at 6 months for caregivers whose loved ones were randomized to the intervention arm. CONCLUSIONS The integration of screening and symptom management into cancer care is recommended. Cancer 2016;122:1270-82.

Original languageEnglish (US)
Pages (from-to)1270-1282
Number of pages13
Issue number8
StatePublished - Apr 15 2016


  • biobehavioral psychology oncology
  • collaborative care
  • depression
  • pain
  • quality of life

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting'. Together they form a unique fingerprint.

Cite this