# A Nurse-Led Palliative and Supportive Care Intervention for Newly Diagnosed Adults with Acute Myeloid Leukemia

> **NIH NIH R34** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2022 · $194,375

## Abstract

7. PROJECT SUMMARY/ABSTRACT
Acute myeloid leukemia (AML) is a serious illness of older adults (>60) which carries a high risk of mortality and
negatively impacts daily function and quality of life (QOL). Prognosis is poor; over two-thirds of patients will not
survive 5 years. Recently, approval of oral venetoclax (VEN) in addition to infusional hypomethylating agents
(HMAs) has improved treatment efficacy substantially for older adults, and protocols now typically are to receive
the first cycle of treatment during 7 days in the hospital and then return home for 21 days of treatment with
caregivers more actively involved. Patients are at high risk for fatigue, which leads to functional decline and
subsequent deterioration in quality of life (QOL), interfering with their return to independent living. We propose
to address symptoms and function management early in AML treatment using a PAlliative and Collaborative
Care inTervention (PACT) delivered by clinical staff who receive basic training in palliative and supportive care
to bridge this gap in care and address QOL. Patients highly prize freedom from symptoms and ability to move
about as important aspects of QOL. Accordingly, PACT targets symptom management and prevention of
functional decline as mechanisms through which QOL is supported. PACT is an interdisciplinary nurse-led
intervention of nursing [RN], occupational therapy [OT], physical therapy [PT] for adults ≥ 60 years of age to
begin within two days of hospital admission. Guided by the Adaptive Leadership Framework for Chronic Illness,
the PACT team works with the patient to assess and manage their symptoms (e.g. anxiety, depressive
symptoms, pain, fatigue, sleep disturbance, cognition) and to optimize function (e.g Activity Measure for Post-
Acute Care, function) to address QOL outcomes (i.e. symptoms, function domains). PACT empowers patients
with self-management skills to reduce symptoms and optimize function during this period of serious illness. The
team and patient identify and address emotional, motivational, attitudinal barriers so that the patient can do the
work required for self- management to reduce symptoms and avoid functional decline. Our primary objective is
to assess feasibility, acceptability, and change in pre and post measures of QOL, symptoms, function, and
readiness for discharge in 2 cycles (total of 60 days) of HMA + VEN regimen. We propose a two-year planning
project with these aims: 1) Determine feasibility and acceptability of study methods and examine changes in
pre- and post- treatment measures of function, patients' self-report of symptoms and QOL, and patients and
caregivers' post self-report of readiness for discharge. We will include 10 control and 10 intervention patients,
and 2) Develop and write R01 proposal based on what is learned from Aim 1. Finalize protocol, establish study
infrastructure including expanding interdisciplinary team; identify and enroll R01 sites, refine recruitment
strategy and oper...

## Key facts

- **NIH application ID:** 10368993
- **Project number:** 5R34NR019131-02
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Ashley Leak Bryant
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $194,375
- **Award type:** 5
- **Project period:** 2021-03-09 → 2023-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10368993

## Citation

> US National Institutes of Health, RePORTER application 10368993, A Nurse-Led Palliative and Supportive Care Intervention for Newly Diagnosed Adults with Acute Myeloid Leukemia (5R34NR019131-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10368993. Licensed CC0.

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