Mobile application to support oncology patients during treatment on patient outcomes: Evidence from a randomized controlled trial

Abstract

Background: Cancer treatment requires substantial demands on patients and their caregivers. Mobile apps can provide support for self-management during oncology treatment, but few have been rigorously evaluated.Methods: A 3-month randomized controlled trial was conducted at a large cancer center to evaluate the efficacy of an app (LivingWith®) that provides selfmanagement support during cancer treatment on quality of life and health care utilization. Patients in chemotherapy treatment were randomized into the intervention (n = 113) and control group (n = 111). Intervention group participants agreed to use the app weekly for 3 months, and all participants completed a survey at enrollment and after 3 months to evaluate changes in quality of life and health care utilization.Results: Retention rate was 75.4% with 169 participants completing the follow-up survey. The intervention group reported 0.74 fewer medical office visits (p = 0.043) and 0.24 fewer visits with a mental health professional (p = 0.061) during the 3 and month intervention compared with controls. There were no significant changes by study group in quality of life, or emergency room and urgent care visits. Among intervention participants, 75.3% reported using the app and on average, used it 11.7 times during the 3-month intervention. Reasons for not using the app among intervention participants included lack of time, lack of interest in apps, and usability challenges. Conclusions and Relevance:Apps are inexpensive and scalable tools that can provide additional support for individuals coping with complex cancer treatments. This trial provides evidence that a well-designed oncology support app used during chemotherapy resulted in fewer clinic visits. Still, nearly a quarter of participants randomized to the intervention arm reported never using the app due to personal preference and usability challenges, which points to future

Guided versus non‐guided digital psychological interventions for cancer patients: A systematic review and meta‐analysis of engagement and efficacy

“…Thirty‐six of 43 (84%) studies reported the proportion of participants who commenced the intervention out of the total number of eligible participants offered enrolment. The proportions were variable, ranging from 35 40 to 97% 41 for guided interventions with a mean of 68%, 36,37,40–52 and 20 50 ‐100% 51 for non‐guided interventions with a mean of 64% 7,34,38,39,53–69 …”

“…Ten studies evaluated the proportion of participants who used the intervention at least once, ranging from 85% 47 to 100% 37,70 for guided, and 52% 58 to 89.4% 56 for non-guided. Eleven studies collected data on the number of separate logins/visits by intervention group participants, with the average number being 9.5 37,70 for guided and 10.6 7,54,58,59,[62][63][64]67,71 for non-guided.…”

“…The proportions were variable, ranging from 35 40 to 97% 41 for guided interventions with a mean of 68%, 36,37,[40][41][42][43][44][45][46][47][48][49][50][51][52] and 20 50 -100% 51 for non-guided interventions with a mean of 64%. 7,34,38,39,[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] Sixty-seven percent (29/43) of studies reported intervention usage, 19 of which (65.5%) were studies of non-guided interventions and 10 (34.5%) were guided (see Table S3, Appendix S1). Nine studies provided data on the proportion of participants using the intervention as intended, defined as 60%-100% completion in the literature.…”

Digital Therapeutics for Improving Effectiveness of Pharmaceutical Drugs and Biological Products: Preclinical and Clinical Studies Supporting Development of Drug + Digital Combination Therapies for Chronic Diseases

“…For patients and healthcare professionals, the main clinical challenges are treatment adherence, symptom monitoring, symptom management, social support, and self-efficacy. Empowering oncology patients using digital technologies has been recognized as a promising strategy to improve therapy outcomes [98][99][100][101][102][103][104].…”

New regulatory thinking is needed for AI-based personalised drug and cell therapies in precision oncology

“…First generation cancer drug-companion apps provide simple digital support to patients undergoing cancer treatment to enhance patient understanding and adherence. They have simple diary, tracking and communications functions 53 , 54 , 70 . Some of these apps use remote monitoring for dose adaptation to side effects, but, due to the increased HCP workload they create, and due to their lack of reimbursement, they have thus far only been used in clinical trials 71 – 73 .…”