Please select the eligibility criteria that correspond to the clinical trial below.
Title: Web-based Support for Caregivers of Veterans Undergoing Chemotherapy
Brief Summary: Given the growing strain on the Veterans Administration resulting from increasing caseloads of cancer patients, interventions are badly needed that assist patients in managing their illness, improve quality of life and avoid acute episodes that result in urgent care use and increased mortality. Previous studies have found that cancer patients undergoing chemotherapy can effectively manage their own symptoms when monitored using automated telephone calls. Such technology, however, may challenge the number of Veterans who lack social support and/or independence. The goal was to develop and test a technology that not only monitors patients automatically by telephone, but also gives them self management advice and engages a friend or family member to serve as a CarePartner willing to play a limited role in identifying patient symptoms and psychosocial needs to reinforce self management and provide social support. The investigators found that this technology indeed helped patients better control their symptoms, especially when a caregiver participated in the program along with them.


Options:
A: Inclusion criteria:

1. Women members of The North Carolina Teachers' and State Employees' Comprehensive Major Medical Plan (SHP)
2. Age 40-75
3. Enrolled with the SHP for at least 24 months, not covered by COBRA or Medicare primary
4. Based on claims data, women will have had their last mammogram 6-8 months ago so reminders will arrive 2 months prior to due date for next mammogram.

Exclusion criteria:

1. Unable to speak and understand English. We lack the resources to adapt the intervention appropriate for non-English speakers. Moreover, we do not know if the interventions lend themselves to cultural translation. We regard this as a next logical research activity.
2. Have breast cancer or have some other illness that precludes participation. Women diagnosed with breast cancer before the study are ineligible; their screening schedules are consistent with recommendations for the general population. However, if women develop breast cancer during the study, we would ask them a reduced set of questions.

We selected age 75 as the upper limit, because there are too few women over age 75 to permit meaningful statistical analysis (\<100 women in all). The SHP is largely a working population. We wish that it were possible both to include and analyze women older than age 75. This is a limitation of the population we have selected.
B: Inclusion Criteria:

* Patients must be 18 years or older, cognitively intact, English-speaking, able to hear, and own a telephone.
* Patients can have any solid tumor.
* Patients must be initiating IV cytotoxic chemotherapy and, if recurrent, have experienced a 1 month treatment free interval.
* Caregivers must be 18 years or older, cognitively intact, English-speaking, and able to hear/speak for interviews.
* Caregivers must have access to a telephone and computer with high speed internet access.

Exclusion Criteria:

* Patients will be excluded if they have a hematologic malignancy or are receiving bone marrow transplantation.
* Patients and caregivers will be excluded if they have an untreated serious mental illness or cognitive impairment, are institutionalized or enrolled in hospice (prior to trial), or plan on not receiving all care from VA
C: Inclusion Criteria:

* spoken language is French or English
* physician is a user of MOXXI (electronic health record system) and patient has consented to be captured by MOXXI
* receiving a high-risk incident prescription
* medication insurance through Regie de l'Assurances Maladie du Quebec (RAMQ) insurance program

Exclusion Criteria:

* patient not appropriate for inclusion (as determined by prescribing physician)
D: DISEASE CHARACTERISTICS:

* Diagnosis of cancer AND 1 or both of the following:

  * Clinical depression

    * Depression must be of at least moderate severity (PHQ-9 score ≥ 10)

      * Depressed mood and/or anhedonia endorsed
    * No depression directly precipitated by cancer therapy for which depression is a well known side effect (e.g., interferon, corticosteroids)
  * Cancer-related pain

    * Pain must be at least moderate in severity (Brief Pain Inventory score ≥ 6), persisted despite using ≥ 2 analgesics, and cancer-related
    * If the only pain is due to a pre-existing condition (e.g., migraine, headache, arthritis, etc), the patient may not be eligible

PATIENT CHARACTERISTICS:

* Life expectancy ≥ 6 months
* Must speak English
* Not pregnant
* Fertile patients must use effective contraception
* No moderately severe cognitive impairment
* No schizophrenia or other psychosis
* No disability claim currently being adjudicated for pain

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* Not in hospice care

Answer: B