Department of Surgery, Seoul National University Hospital, Seoul, Korea.
Department of Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
J Gastric Cancer. 2024 Oct;24(4):420-435. doi: 10.5230/jgc.2024.24.e37.
This study aimed to develop and assess the feasibility and effectiveness of digital therapeutics for supportive care after gastrectomy.
The study included 39 patients with gastric cancer who underwent minimally invasive gastrectomy and were able to use a mobile application (app) on their smartphones. The developed research app automatically calculates and provides daily targets for calorie and protein intake based on the patient's body mass index (BMI). Patients recorded their daily diets, weights, and symptoms in the app and completed special questionnaires to assess the feasibility of the app in real-world clinical practice.
At the 10-week follow-up, the mean questionnaire scores for ease of learning, usability, and effectiveness of the app (primary endpoint) were 2.32±0.41, 2.35±0.43, and 2.4±0.39 (range: 0-3), respectively. Patients were classified as underweight (<18.5, n=4), normal (18.5-24.9, n=24), or overweight (≥25.0, n=11) according to predischarge BMI. Underweight patients showed higher compliance with app usage and a higher rate of achieving the target calorie and protein intake than normal weight and overweight patients (98% vs. 77% vs. 81%, p=0.0313; 102% vs. 75% vs. 61%, P=0.0111; 106% vs. 79% vs. 64%, P=0.0429). Two patients transitioned from underweight to normal weight (50.0%), one patient (4.3%) transitioned from normal weight to underweight, and two patients (22.2%) transitioned from overweight to normal weight.
The mobile app is feasible and useful for postoperative supportive care in terms of ease of learning, usability, and effectiveness. Digital therapeutics may be an effective way to provide supportive care for postgastrectomy patients, particularly in terms of nutrition.
ClinicalTrials.gov Identifier: NCT04800991.
本研究旨在开发并评估用于胃切除术后支持性护理的数字疗法的可行性和有效性。
本研究纳入了 39 例接受微创胃切除术且能够使用智能手机上的移动应用程序（app）的胃癌患者。所开发的研究型 app 会根据患者的体重指数（BMI）自动计算并提供每日卡路里和蛋白质摄入量目标。患者在 app 中记录每日饮食、体重和症状，并完成专门的问卷，以评估 app 在真实临床实践中的可行性。
在 10 周的随访中，app 的易用性、学习难度和有效性的问卷评分（主要终点）分别为 2.32±0.41、2.35±0.43 和 2.4±0.39（范围：0-3）。根据出院时 BMI，患者分为消瘦组（＜18.5，n=4）、正常组（18.5-24.9，n=24）和超重组（≥25.0，n=11）。与正常体重和超重患者相比，消瘦患者对 app 使用的依从性更高，达到卡路里和蛋白质摄入目标的比例也更高（98% vs. 77% vs. 81%，p=0.0313；102% vs. 75% vs. 61%，P=0.0111；106% vs. 79% vs. 64%，P=0.0429）。2 例患者从消瘦转为正常体重（50.0%），1 例患者（4.3%）从正常体重转为消瘦，2 例患者（22.2%）从超重转为正常体重。
该移动 app 在学习难度、易用性和有效性方面，用于术后支持性护理是可行且有用的。数字疗法可能是为胃切除术后患者提供支持性护理的有效方法，尤其是在营养方面。
ClinicalTrials.gov 标识符：NCT04800991。
