Areej El-Jawahri, MD

Scalable Supportive Care Interventions to Improve the Quality of Life and Care for Patients with Blood Cancers and their Caregivers

I am a passionate clinician scientist whose life mission is to improve the lived experience of patients with blood cancers and their caregivers. My research interests are fueled by my clinical practice as an oncologist caring for these patients and their families and witnessing their daily struggles navigating their illness and often prolonged treatment course. I am focused on developing scalable supportive care interventions to improve the quality of life (QOL) and care for patients with blood cancers and their caregivers across the continuum of their illness.

Patients with blood cancers are often very ill from both the disease itself and the intensive treatments, which often require prolonged and socially isolating hospitalizations that can cause immense physical and psychological distress. Even survivors of blood cancers struggle with post-treatment complications that diminish their QOL. I have developed and tested several clinician-delivered supportive care interventions which have been shown to improve QOL, reduce psychological distress, and promote effective coping among patients with blood cancers and their caregivers. Unfortunately, only a minority of patients with blood cancers and their caregivers have access to these interventions, even in academic medical centers, due to the limited availability of trained supportive care clinicians such as psychologists, social workers, and specialty palliative care clinicians.

To ensure all patients with blood cancers and their caregivers have access to the wide range of supportive care services available, we must develop new delivery modalities, such as digital therapeutic interventions, that can be prescribed for patients and families. The support provided by the MGH Research Scholar award will help in developing and testing the following interventions:

• A multicomponent virtual reality (VR) intervention for patients with blood cancers receiving intensive therapies during prolonged hospitalizationsWe recently adapted the active components of our specialty palliative care interventions for patients experiencing prolonged hospitalization for treatment of blood cancers to a multicomponent VR intervention that patients can self-administer. This is a potentially scalable, patient-centered strategy to address the isolation and the myriad of unmet supportive care needs of patients with blood cancers experiencing prolonged hospitalizations. We hope to test the efficacy of the VR intervention for improving the QOL and care for patients with blood cancers experiencing prolonged hospitalizations.
• Horizons App: A Survivorship Digital App for Patients Living with Chronic Graft-Versus-Host Disease (cGVHD)Hematopoietic stem cell transplantation (HSCT) is a common potentially curative treatment for many patients with blood cancers. Yet, 30-50% of HSCT survivors develop cGVHD, a debilitating immunologic syndrome that attacks multiple organs and is the major cause of post-HSCT morbidity and mortality. Patients with GVHD struggle to manage their illness, which often results in substantial physical symptoms, functional limitations and impaired QOL.

We recently adapted our multicomponent group-based intervention (Horizons) into a patient-centered, survivorship digital app (Horizon App) for patients with cGVHD that integrates state-of-the-science medical information with behavioral strategies to improve self-management, self-efficacy and coping in the face of this debilitating disease. We will test the efficacy of the Horizons App for improving cGVHD symptom burden, QOL, and care for patients living with cGVHD.

I am so incredibly honored to be named a MGH Research Scholar. The support of the MGH Research Scholars program will be instrumental in expanding our novel digital health research platform to ensure that all patients with blood cancers and their caregivers have access to timely and critical supportive care services that can be easily disseminated across cancer centers nationally and globally and integrated into routine clinical care.