Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
Department of Psychology, Health & Technology, University of Twente, Enschede, the Netherlands.
Psychooncology. 2020 Nov;29(11):1823-1834. doi: 10.1002/pon.5492. Epub 2020 Oct 11.
This waiting-list randomized controlled trial examined the effectiveness of a self-management mHealth app in improving fatigue and quality of life (QoL) in cancer patients and survivors.
Persons with cancer-related fatigue (CRF) were recruited across four English speaking countries, via social media, and randomized into intervention (n = 519) and control (n = 280) groups. Whereas the intervention group received immediate access to the Untire app, the control group received access only after 12-weeks. Primary outcomes fatigue severity and interference, and secondary outcome QoL were assessed at baseline, 4, 8, and 12-weeks. We ran generalized linear mixed models for all outcomes to determine the effects of app access (yes/no), over 12-weeks, following the intention-to-treat principle.
Compared with the control group, the intervention group showed significantly larger improvements in fatigue severity (d = 0.40), fatigue interference (d = 0.35), and overall QoL on average (d = 0.32) (P's < .01), but not for overall QoL in the past week (P = .07). Sensitivity analyses indicated that participants with medium or high app use benefited most when compared with nonusers and control participants (P's ≤ .02). The intervention effect on fatigue interference was slightly stronger in younger participants (≤56 vs. >56). Effects did not depend on education and cancer status. Reliable change analyses indicated that significantly more people showed full recovery for fatigue in the intervention vs the control group (P's = .02).
The Untire app can be an effective mHealth solution for cancer patients and survivors with moderate to severe CRF.
本候补随机对照试验旨在研究自我管理型移动医疗应用程序对改善癌症患者和幸存者疲劳和生活质量(QoL)的有效性。
通过社交媒体在四个英语国家招募癌症相关性疲劳(CRF)患者,并将其随机分为干预组(n = 519)和对照组(n = 280)。干预组可立即访问 Untire 应用程序,而对照组仅在 12 周后才可访问。在基线、4 周、8 周和 12 周评估主要结局疲劳严重程度和干扰,以及次要结局 QoL。我们使用广义线性混合模型对所有结局进行分析,以确定应用程序访问(是/否)在 12 周内的效果,遵循意向治疗原则。
与对照组相比,干预组在疲劳严重程度(d = 0.40)、疲劳干扰(d = 0.35)和总体 QoL 上的改善更为显著(平均 d = 0.32)(P 值均<.01),但在过去一周的总体 QoL 上无显著差异(P =.07)。敏感性分析表明,与非使用者和对照组参与者相比,中等或高应用程序使用者获益最大(P 值均≤.02)。在年轻参与者(≤56 岁 vs. >56 岁)中,干预对疲劳干扰的效果略强。效果不依赖于教育和癌症状态。可靠变化分析表明,与对照组相比,干预组中疲劳完全缓解的人数显著更多(P 值均=.02)。
Untire 应用程序可为中重度 CRF 的癌症患者和幸存者提供一种有效的移动医疗解决方案。