Impact of a proactive telephone intervention led by the advanced practice nurse aimed at symptom control and toxicity detection on the quality of life of outpatients with lung cancer undergoing treatment

BackgroundPatients with advanced lung cancer have significant burden of symptoms and can suffer treatment-related adverse events, which negatively impact their quality of life and emotional well-being. The objective was to evaluate the impact of a proactive telephone educational intervention led by the advanced practice nurse (APN) for symptom control, earlier detection of toxicities in outpatients with advanced lung cancer, comparing its effectiveness with reactive care during the first two months of treatment.MethodsQuasi-experimental design in which consecutive patients were allocated 1:1 to the intervention group (IG) or to the control group (CG) and identified in the functional lung unit Feb 2023 - Feb 2024. IG received a proactive telephone educational intervention led by the APN, while CG received reactive telephone care. Quality of life, anxiety, depression, intensity of symptoms, toxicities, healthcare requirements and satisfaction were evaluated using validated and ad-hoc questionnaires Statistical analysis using R software.Results60 patients were enrolled in each group with 4 losses in the post evaluation. Median age:60-75 years (68.3% IG; 70% CG),men (76.7% IG; 65% CG), adenocarcinoma and squamous cell histology (76.6% IG; 80% GC) and similar sociodemographic and treatment characteristics. IG had reduction in symptom burden: asthenia (IG 35.1%; CG 17.9%, p=0.011), anorexia (IG 78.9%; CG 46.4%, p=0.00029) and a percentage of patients without dyspnea 15%, cough 15.2%, pain 9.7%, sleep disturbances 11.5%, constipation 27.3% and reduction in toxicities: mucositis, esophagitis, asthenia, nausea, vomiting and respiratory toxicities (all p<0.05). Improvement in quality of life (IG 1.75/100; CG 0.16/100) and anxiety levels (IG 1.37/21; CG 1/21). Increase in depression in CG 5.7/21; IG 5.05/21. IG expressed greater satisfaction with proactive phone attention (score: 9.54/10, p=0.000587) and had more chances to consult with APN and detecting their needs.ConclusionsProactive phone follow-up appears to improve quality of life, to reduce symptoms, toxicities, anxiety, and to increase patient satisfaction with advanced lung cancer.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.