移动应用程序在治疗肿瘤患者期间支持患者结局：一项随机对照试验的证据。

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

机构信息

Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.

West Cancer Center and Research Institute, Germantown, Tennessee, USA.

出版信息

Cancer Med. 2023 Mar;12(5):6190-6199. doi: 10.1002/cam4.5351. Epub 2022 Oct 18.

DOI:10.1002/cam4.5351

PMID:36258654

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10028030/

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 self-management 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 opportunities for calibrating target user population and improving user-centered design.

CLINICALTRIALS

gov identifier: NCT04331678.

摘要

背景

癌症治疗对患者及其护理人员都有很高的要求。移动应用程序可以为肿瘤治疗期间的自我管理提供支持，但很少有经过严格评估的。

方法

在一家大型癌症中心进行了一项为期 3 个月的随机对照试验，以评估一种提供肿瘤治疗期间自我管理支持的应用程序（LivingWith®）对生活质量和医疗保健利用的疗效。接受化疗治疗的患者被随机分为干预组（n=113）和对照组（n=111）。干预组的参与者同意在 3 个月内每周使用该应用程序，所有参与者在入组时和 3 个月后完成一项调查，以评估生活质量和医疗保健利用的变化。

结果

169 名参与者完成了随访调查，保留率为 75.4%。与对照组相比，干预组在 3 个月的干预期间报告的医疗办公室就诊次数减少了 0.74 次（p=0.043），心理健康专业人员就诊次数减少了 0.24 次（p=0.061）。研究组的生活质量或急诊和紧急护理就诊次数没有显著变化。在干预组参与者中，75.3%的人报告使用了该应用程序，平均在 3 个月的干预期间使用了 11.7 次。干预组参与者未使用该应用程序的原因包括没有时间、对应用程序不感兴趣和可用性挑战。

结论和相关性

应用程序是一种廉价且可扩展的工具，可以为应对复杂癌症治疗的个人提供额外支持。这项试验提供了证据，表明在化疗期间使用精心设计的肿瘤学支持应用程序可以减少就诊次数。尽管如此，近四分之一被随机分配到干预组的参与者报告从未使用过该应用程序，原因是个人偏好和可用性挑战，这为针对目标用户群体进行调整和改进以用户为中心的设计提供了未来机会。