During their hospitalization for rigorous chemotherapy, patients with Acute Myeloid Leukemia (AML) reported a significant deterioration in their quality of life (QOL) and mood. At Massachusetts General Hospital and Dana-Farber Cancer Institute, researchers conducted a randomized trial of a psychological mobile app (DREAMLAND) for patients with a new diagnosis of AML who were receiving rigorous chemotherapy. Patients were allocated to either DREAMLAND or standard care at random. DREAMLAND was explicitly designed for patients on the AML path and included four mandatory modules: supportive psychotherapy to help patients cope with the initial shock of diagnosis; psychoeducation to manage illness expectations; psychosocial skill-building to promote effective coping; and self-care. The primary outcome was feasibility, defined as enrolling at least 60% of eligible patients and having 60% of recruited complete at least 60% of the needed modules. At baseline and day +20 post-chemotherapy, investigators assessed patient QOL (Functional-Assessment-of-Cancer-Therapy-Leukemia), psychological distress (Hospital-Anxiety-and-Depression-Scale [HADS], and Patient-Health-Questionnaire-9 [PHQ-9]), symptom burden (Edmonton-Symptom-Assessment-Scale), and self-efficacy (Cancer Self To analyze the impact of DREAMLAND on outcomes, they employed ANCOVA. About 66.7% (60/90) of eligible patients were enrolled, with 62.1% completing 75% of the intervention modules. Patients randomized to DREAMLAND had better QOL (132.06 vs. 110.72, P=0.001), reduced anxiety (3.54 vs. 5.64, P=0.010), and lower depression (HADS: 4.76 vs. 6.29, P=0.121; PHQ-9: 4.62 vs. 8.35, P<0.001) symptoms, as well as improved symptom load (24.89 vs. 40.60, P=0.007). A psychological mobile app for patients newly diagnosed with AML might increase QOL, mood, symptom load, and self-efficacy during hospitalization for rigorous treatment.
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