Assessing the impact of app-delivered lighting interventions on fatigue in three populations of cancer patients

评估应用程序提供的照明干预措施对三组癌症患者疲劳的影响

• 批准号: 10262965
• 负责人: Olivia Walch
• 金额: $ 73.94万
• 依托单位: ARCASCOPE, INC
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-12 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10262965
• 关键词: Adoption; Affect; Aftercare; Algorithms; Anxiety; Autologous Stem Cell Transplantation; Awareness; Back; Behavioral; Biological Clocks; Breast; Cancer Center; Cancer Patient; Cancer Survivor; Chronotherapy; Circadian Dysregulation; Circadian Rhythms; Clinical Trials; Cognitive Therapy; Comprehensive Cancer Center; Computer software; Data; Exercise; Fatigue; Feedback; Goals; Gold; Guidelines; Hygiene; Individual; Inferior; Intervention; Light; Lighting; Link; Location; Malignant Neoplasms; Measures; Melatonin; Methods; Michigan; Moods; Outcome; Participant; Pathway interactions; Patients; Phase; Phototherapy; Population; Prostate; Provider; Quality of life; Randomized Controlled Trials; Recommendation; Research; Risk; Schedule; Sleep; Sleep disturbances; Small Business Innovation Research Grant; Symptoms; Testing; Therapeutic; Time; Toxic effect; Treatment Side Effects; Universities; Update; Work; base; cancer therapy; cancer type; circadian; circadian pacemaker; environmental change; experience; fitbit; improved; metastatic colorectal; mobile application; novel; patient population; phase I trial; primary outcome; prospective; psychosocial; recruit; reduce symptoms; repaired; secondary outcome; side effect; sleep quality; survival outcome; technological innovation; time use; treatment response; wearable device

ABSTRACT Cancer patients often experience disruptions to their body's internal, circadian clock over the course of treatment, which contribute to worsened side-effects and quality of life. These side-effects include cancer- related fatigue (CRF), which affects millions of patients and can persist for months to years after the end of treatment. Despite the pervasiveness of CRF, the guidelines for treating it are largely limited to exercise, cognitive behavioral therapy, and other psychosocial interventions, which present challenges of compliance, accessibility, and scalability. Light therapy, however, has a lower barrier to entry and has shown promise as a way of reducing symptoms of fatigue in cancer patients by targeting circadian pathways. Light is the primary input to the body's internal clock. By timing light exposure-- e.g., increasing morning light and decreasing light at night-- lighting interventions can bolster the clock, improving fatigue and consolidating sleep. The advantages of a more robust clock may also go beyond fatigue and sleep, as better outcomes in cancer patients are associated with less disrupted circadian rhythms. Despite the potential value in light interventions, several limitations have held back their wide-spread adoption as a treatment. There is limited awareness about how light timing affects the circadian clock, which is complicated by the fact that the clock's sensitivity to light changes over the course of the day. In addition, any lighting interventions need to be tailored to an individual's “personal time zone” (i.e., their circadian clock's current state) in order to be effective. Two individuals living in the same location may need light at markedly different times if their daily schedules are sufficiently different, or if one's circadian clock is much more disrupted than the other. The work in this proposal is a clinical trial to test an app (“SHIFT”) that recommends personalized lighting interventions to reduce fatigue in cancer patients. 138 patients will be recruited from the University of Michigan's Cancer Center and provided with the SHIFT app, as well as a pair of blue-blocking glasses and a Fitbit wearable device. The patients will be tracked longitudinally, with fatigue as the primary outcome, and sleep disturbances, sleep aid usage, mood, and anxiety as secondary outcomes. We expect to observe statistically significant differences in fatigue as a result of targeted lighting interventions. The final product will be a quantification of the SHIFT app's ability to improve fatigue in cancer patients and a roadmap for iteratively improving the app.

抽象的 癌症患者在治疗过程中经常会经历身体内部生物钟的紊乱 治疗，这会导致副作用和生活质量恶化，这些副作用包括癌症- 相关疲劳（CRF），影响着数百万患者，并且可能在疾病结束后持续数月至数年。 尽管 CRF 很普遍，但治疗指南主要限于运动、 认知行为疗法和其他心理社会干预措施对依从性提出了挑战， 然而，光疗法的进入门槛较低，并且已显示出作为一种治疗方法的前景。 通过针对昼夜节律途径来减轻癌症患者疲劳症状的方法是光是主要的。 通过定时光照——例如增加早晨的光照和减少光照。 晚上——照明干预可以提高生物钟、改善疲劳并巩固睡眠。 更强大的生物钟的优势可能不仅仅限于疲劳和睡眠，因为癌症治疗效果更好 尽管轻度干预具有潜在价值，但患者的昼夜节律紊乱较少。 一些局限性阻碍了其作为一种治疗方法的广泛采用。人们对它们的认识有限。 光时间如何影响生物钟，由于生物钟对光的敏感性，这一点变得复杂 此外，任何照明干预措施都需要根据个人的情况进行调整。 “个人时区”（即他们的生物钟的当前状态），以便两个人生活在一起。 如果他们的日程安排有很大差异，那么同一地点可能在明显不同的时间需要照明，或者 一个人的生物钟是否比另一个人受到更多干扰 该提案中的工作是一项临床试验来测试。 一款建议个性化照明干预措施以减轻癌症患者疲劳的应用程序（“SHIFT”）138。 将从密歇根大学癌症中心招募患者并为其提供 SHIFT 应用程序，因为 以及一副防蓝光眼镜和一个 Fitbit 可穿戴设备，将对患者进行纵向追踪， 以疲劳为主要结局，睡眠障碍、助眠剂的使用、情绪和焦虑为主要结局 我们期望观察到有针对性的疲劳带来的统计上的显着差异。 最终产品将是 SHIFT 应用改善疲劳能力的量化结果。 癌症患者和迭代改进应用程序的路线图。