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Cited by 2Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeTelemedicine and Telehealth Implementation

Symptom management interventions influence unscheduled health services use among cancer survivors and caregivers

Open access
Badger, Terry, Segrin, Chris, Crane, Tracy E., Chalasani, Pavani, Arslan, Waqas, Hadeed, Mary, Cunicelli, Nathan, Given, Charles W. +1 more·2026·Journal of Cancer Survivorship
DOI 10.1007/s11764-024-01723-yPMC PMC12151082
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Abstract

Purpose Three sequences of telephone symptom management interventions were tested on use of unscheduled health services among cancer survivors with depressive or anxiety symptoms during treatment (N = 334) and their informal caregivers (N = 333). Methods The three 12-week intervention sequences were as follows: (1) Symptom Management and Survivorship Handbook (SMSH), (2) a combined 8-week SMSH + Telephone Interpersonal Counseling (TIPC) followed by SMSH for 4 weeks, and (3) SMSH for 4 weeks followed by a combined SMSH + TIPC if no response to SMSH alone. Survivor-caregiver dyads were first randomized to SMSH or a combined SMSH + TIPC. If the survivor's depressive or anxiety symptoms persisted after 4 weeks of SMSH alone, the dyad was randomized the second time to continue with SMSH alone or TIPC was added to SMSH. All participants were assessed at baseline and 13 and 17 weeks. Health service use was compared between randomized groups and among the three sequences. Results Survivors were 60.2 years of age, 79% were female, and 41% were Hispanic. Caregivers were 54.8 years of age; 67% were female. The significantly lower rate of emergency department (ED) or urgent care visits for survivors was found in the SMSH + TIPC intervention sequence compared to the SMSH alone in the second randomization and for the third intervention sequence compared to the first. Conclusions Adding TIPC to SMSH after week 4 when survivors experienced persisting depressive or anxiety symptoms reduced ED/urgent care visits compared to SMSH alone. Implications for cancer survivors Managing depression and anxiety symptoms may help prevent ED/urgent care visits and worsening of other symptoms.

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  • High caregiver distress is associated with poorer quality of care, greater unplanned health care use, and higher caregiver symptom burden.

    “High caregiver distress is associated with poorer quality of care, 16 greater unplanned health care use, 114 , 115 and higher caregiver symptom burden. 116”

    From Nonpharmacologic interventions for managing distress, anxiety, and depression for patients with cancer and their family caregivers: A systematic review and meta‐analysis (2026) · cites this paper as [114]

    The Introduction (page unavailable) says symptom burden often drives unscheduled health-service use and identifies psychological distress among symptoms reported by cancer caregivers. It does not establish that caregivers with higher distress have greater unplanned health-care use; the association it explicitly reports for greater use is with younger age and more comorbid conditions. The other clauses of the citing sentence have separate citations and are not assessed here. (LLM, conf=0.78)

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Research works printed but not linked: 4

  1. [3]Shelburne N, Simonds NI, Jensen RE, Brown J. Cancer-related emergency and urgent care: expanding the research agenda. Emergency Cancer Care. 2022; 1(4)doi: 10.1186/s44201-002-00005-6 PMC9194780 35844668 · DOI
  2. [37]Sikorskii A, Badger TA, Segrin C, A Sequential Multiple Assignment Randomized Trial of Symptom Management After Chemotherapy. J Pain Symptom Manage. Jun 2023; 65(6): 541– 552 e2. doi: 10.1016/j.jpainsymman.2023.02.005 36801353 PMC10192117 · DOI
  3. [40]Weissman M, Markowitz J, Klerman G. The Guide to Interpersonal Psychotherapy: Updated and expanded edition. Oxford University Press; 2018.
  4. [54]Given C, Bradley C, You M, Sikorskii A, Given B. Costs of novel symptom management interventions and their impact on hospitalizations. J Pain Symptom Manage. 2010; 39(4): 66– 72. PMC2859211 20413054

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Authors
Badger, T., Segrin, C., Crane, T. E., Chalasani, P., Arslan, W., Hadeed, M., Cunicelli, N., Given, C. W., & Sikorskii, A.
Affiliations
  • University of Arizona (US)
  • University of Miami (US)
  • George Washington University (US)
  • Michigan State University (US)
Corresponding author
Badger, Terry
ORCID
Venue
Journal of Cancer Survivorship
Publisher
Springer Science and Business Media LLC
Published
2024-11-29
Volume
20
Issue
2
Pages
595-607
ISSN
  • 1932-2259 (ISSN-L)
  • 1932-2267
DOI
10.1007/s11764-024-01723-y
PMC
PMC12151082
OpenAlex
W4404858361
Cited by
1
References
45
Citations by year
2025: 1
FWCI
0.17
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Cancer Survivorship (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • This study was supported by the National Institutes of Health. PI: Terry Badger. (R01 CA224282)
  • Data collection by the Behavioral Intervention and Measurement Shared Resource at the University of Arizona Cancer Center (PI: C. Thomson). (P30 CA023074)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
cancer survivors, informal caregivers, depressive symptoms, anxiety symptoms, emergency department visits, urgent care visits, dyadic intervention, intervention sequencing
MeSH terms
Cancer Survivors, Adult, Aged, Anxiety, Depression, Female, Humans, Male, Middle Aged, Neoplasms, Patient Acceptance of Health Care, Telephone, Caregivers

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