Oncology Associated Symptoms and Individualized strategies (OASIS): Precision symptoms management for rural patients with advanced cancer.

Abstract

e23155 Background: Rural cancer patients have limited access to symptom management specialists. OASIS is an 8-week, web-based intervention addressing this access gap by providing the right symptom management to the right patients at the right time. This feasibility study seeks to describe recruitment and retention patterns and evaluate symptom severity, distress, and interference at 4, 8, and 12 weeks. Methods: Eligibility included: advanced cancer diagnosis, > 18 years old, and living in small town or rural area. Reasons for non-enrollment and dropout were collected. Descriptive statistics were calculated to evaluate recruitment and retention rates along with symptom severity and interference at each time point. The mean severity and distress scores using the 0-10 NRS of the five symptoms with the highest rating was computed for each time point (i.e., baseline, week 4, and week 8). By averaging the five highest rated symptoms, we evaluated the worst symptoms the individual is experiencing at each data point. Results: Fifty-nine people were approached about the study over 18 months, 38 people signed consents, 12 dropped before completing baseline questionnaires, and 9 completed baseline questionnaires but did not start the intervention. Seventeen people completed baseline questionnaires and started the intervention. The recruitment rate was 66%, the retention rates were 50% and 33% at 4 and 12 weeks.Reasons for drop out included lack of bothersome symptoms, too busy, and generally overwhelmed. Mean age of sample was 62 years and majority men (62.5%). Fatigue (M = 6.4), drowsiness (M = 5.4), numbness/tingling (M = 4.4), and sleep disturbance (M = 4.4) were the most severe symptoms at baseline. Mean symptom severity was M = 3.03 and mean interference was M = 2.53 at baseline. For participants who received the full OASIS-WN intervention, between baseline and week 8, the mean interference rating decreased by 1.6±2.1 points (p = .019), mean severity and distress ratings for the five worst symptoms decreased by 1.72±1.72 (p = .004) and 2.2±2.4 (p = .006), respectively. Conclusions: Symptom severity, distress, and interference improved for participants who received the full intervention. Reasons for early drop out suggest symptom management ought to be provided when the situation is optimal for learning. Future research will evaluate the efficacy of OASIS.