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)

Heidi S. Donovan, Susan M. Sereika, Lari B. Wenzel, Robert P. Edwards, Judith E. Knapp, Susan H. Hughes, Mary C. Roberge, Teresa H. Thomas, Sara Jo Klein, Michael B. Spring, Susan Nolte, Lisa M. Landrum, A. Catherine Casey, David G. Mutch, Robert L. Debernardo, Carolyn Y. Muller, Stephanie A. Sullivan, Sandra E. Ward

Research output: Contribution to journalArticlepeer-review

Abstract

PURPOSEGOG-259 was a 3-arm randomized controlled trial of two web-based symptom management interventions for patients with recurrent ovarian cancer. Primary aims were to compare the efficacy of the nurse-guided (Nurse-WRITE) and self-directed (SD-WRITE) interventions to Enhanced Usual Care (EUC) in improving symptoms (burden and controllability) and quality of life (QOL).METHODSPatients with recurrent or persistent ovarian, fallopian, or primary peritoneal cancer with 3+ symptoms were eligible for the study. Participants completed baseline (BL) surveys (symptom burden and controllability and QOL) before random assignment. WRITE interventions lasted 8 weeks to develop symptom management plans for three target symptoms. All women received EUC: monthly online symptom assessment with provider reports; online resources; and every 2-week e-mails. Outcomes were evaluated at 8 and 12 weeks after BL. Repeated-measures modeling with linear contrasts evaluated group by time effects on symptom burden, controllability, and QOL, controlling for key covariates.RESULTSParticipants (N = 497) reported mean age of 59.3 ± 9.2 years. At BL, 84% were receiving chemotherapy and reported a mean of 14.2 ± 4.9 concurrent symptoms, most commonly fatigue, constipation, and peripheral neuropathy. Symptom burden and QOL improved significantly over time (P <.001) for all three groups. A group by time interaction (P <.001) for symptom controllability was noted whereby both WRITE intervention groups had similar improvements from BL to 8 and 12 weeks, whereas EUC did not improve over time.CONCLUSIONBoth WRITE Intervention groups showed significantly greater improvements in symptom controllability from BL to 8 and BL to 12 weeks compared with EUC. There were no significant differences between Nurse-WRITE and SD-WRITE. SD-WRITE has potential as a scalable intervention for a future implementation study.

Original languageEnglish
Pages (from-to)1464-1473
Number of pages10
JournalJournal of Clinical Oncology
Volume40
Issue number13
DOIs
StatePublished - May 1 2022

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