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Grant Details

Grant Number: 5R01CA204193-05 Interpret this number
Primary Investigator: Krouse, Robert
Organization: University Of Pennsylvania
Project Title: Ostomy Telehealth Self-Management Training for Cancer Survivors
Fiscal Year: 2023


Abstract

Cancer survivors with ostomies, most commonly rectal and bladder cancers, face complex adjustment issues. Typically, post-operative care does not adequately prepare cancer survivors for ostomy self-management, behavior change, psychological support or healthy living, which is requisite to assure optimal Health-Related Quality of Life (HRQOL). We developed an ostomy nurse and peer ostomate-led post-treatment chronic care- based Ostomy Self-Management Telehealth program (OSMT). This program is an education and support curriculum delivered in the group setting for both cancer survivors and their caregiver/support person. We received positive pilot feasibility results, but encountered major access barriers in patients getting to a centralized location to participate in the program. Therefore, we are utilizing telehealth as a delivery method to improve cancer survivor ability to participate. For this study, we will target patients living in rural and other nonmetro areas. The proposal is a randomized controlled study of our self-management program delivered by telehealth intervention compared to an Attention Control Condition (ACC) group. We expect OSMT subjects will improve patient activation, self-efficacy, HRQOL and knowledge via: 1) techniques for self-management to handle frustration, fatigue, pain, isolation, equipment, social situations; 2) overcoming barriers to appropriate exercise; 3) communication skills; 4) nutrition, menu planning, meal timing. In addition, we hope to show a cost benefit to the program, and evidence of reimbursement in the community. Aim 1: Using our enhanced telehealth techniques, determine if patient activation (PA), self-efficacy, ostomy- related knowledge, and HRQOL are improved and sustained over time, comparing OSMT and attention control condition (ACC) groups in rural populations. Aim 2: Determine whether third-party reimbursement for telehealth care encounters are comparable to those for in-person visits and adequate for supporting our OSMT intervention in rural areas.



Publications

Intimacy and survivors of cancer with ostomies: findings from the Ostomy Self-management Training trial.
Authors: Nehemiah A. , Zhang S. , Appel S. , Dizon D. , Sun V. , Grant M. , Holcomb M.J. , Hornbrook M.C. , Krouse R.S. .
Source: The journal of sexual medicine, 2023-10-31; 20(11), p. 1319-1324.
PMID: 37769350
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Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial.
Authors: Krouse R.S. , Anderson G.L. , Arnold K.B. , Thomson C.A. , Nfonsam V.N. , Al-Kasspooles M.F. , Walker J.L. , Sun V. , Alvarez Secord A. , Han E.S. , et al. .
Source: The lancet. Gastroenterology & hepatology, 2023 Oct; 8(10), p. 908-918.
EPub date: 2023-08-01.
PMID: 37541263
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