Ward 2, Gynaecological Oncology Centre, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Department of Nutrition, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
JMIR Mhealth Uhealth. 2024 Nov 4;12:e56475. doi: 10.2196/56475.
As the most malignant type of cancer in the female reproductive system, ovarian cancer (OC) has become the second leading cause of death among Chinese women. Chemotherapy is the main treatment for patients with OC, and its numerous adverse effects can easily lead to malnutrition. It is difficult to centrally manage patients with OC in the intervals between chemotherapy. The use of WeChat, an effective mobile tool, in chronic disease management has been highlighted.
This study aimed to implement a continuous follow-up strategy and health monitoring based on the WeChat platform for patients with OC undergoing chemotherapy to ensure that each phase of chemotherapy was delivered on schedule and to improve the survival rate of patients with OC.
Participants were recruited and randomly assigned to either the WeChat-based nutrition intervention group or the usual care group. A self-administered general information questionnaire was used at enrollment to obtain basic information about the patients. The Patient-Generated Subjective Global Assessment (PG-SGA) Scale was used to investigate the nutritional status of the patients at 3 time points (T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). The blood indices of patients were investigated through the inhospital health care system at 3 times（T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). Patients in the intervention group were introduced to the nutrition applet, invited to join the nutrition management group chat, and allowed to consult on nutritional issues in private chats with nutrition management team members. Linear mixed models were used to analyze changes in each nutritional indicator in the 2 groups, with their baseline measurements as covariates; with group, time, and group-time interactions considered as fixed effects; and with patients considered as random effects.
A total of 96 patients with OC undergoing chemotherapy were recruited into the study. Distribution was based on a 1:1 ratio, with 48 patients each in the nutrition intervention group and the usual care group. The attrition rate after the first chemotherapy session was 18.75%. The mixed linear model revealed that the group-based effect and the group-time interaction effect on PG-SGA scores were significant (F38,38=4.763, P=.03; F37,37=6.368, P=.01), whereas the time-based effect on PG-SGA scores was not (F38,38=0.377; P=.54). The findings indicated that the group-based effect, the time-based effect, and the group-time interaction effect on nutrition-inflammation composite indices were significant (F38,38=7.653, P=.006; F38,38=13.309, P<.001; F37,37=92.304, P<.001; F37,38=110.675, P<.001; F38,38=10.379, P=.002; and F37,37=5.289, P=.02).
This study provided evidence that a WeChat-based, multidisciplinary, full-course nutritional management program can significantly improve the nutritional status of patients with OC during chemotherapy.
卵巢癌是女性生殖系统中最恶性的癌症类型，已成为中国女性死亡的第二大主要原因。化疗是 OC 患者的主要治疗方法，其众多不良反应容易导致营养不良。在化疗间隔期间，对 OC 患者进行集中管理具有一定难度。微信是一种有效的移动工具，在慢性病管理中的应用已经得到了强调。
本研究旨在基于微信平台为接受化疗的 OC 患者实施持续随访策略和健康监测，以确保每个化疗阶段都能按时进行，并提高 OC 患者的生存率。
招募参与者并随机分配到微信营养干预组或常规护理组。在入组时使用自我管理的一般信息问卷获取患者的基本信息。在 3 个时间点（T0=首次入院化疗前，T1=首次化疗后 2 周，T6=第六次化疗后 2 周）使用患者生成的主观整体评估量表（PG-SGA）评估患者的营养状况。通过住院健康护理系统在 3 次（T0=首次入院化疗前，T1=首次化疗后 2 周，T6=第六次化疗后 2 周）调查患者的血液指标。干预组患者被介绍到营养小程序中，邀请他们加入营养管理组聊，允许他们与营养管理团队成员进行私人聊天咨询营养问题。使用线性混合模型分析两组中每个营养指标的变化，以其基线测量值作为协变量；考虑组、时间和组-时间交互作用作为固定效应；并将患者视为随机效应。
共有 96 名接受化疗的 OC 患者被纳入研究。按照 1:1 的比例分配，营养干预组和常规护理组各有 48 名患者。第一次化疗后的失访率为 18.75%。混合线性模型显示，PG-SGA 评分的组间效应和组-时间交互效应具有统计学意义（F38,38=4.763，P=.03；F37,37=6.368，P=.01），而时间对 PG-SGA 评分的效应无统计学意义（F38,38=0.377；P=.54）。结果表明，营养-炎症综合指数的组间效应、时间效应和组-时间交互效应具有统计学意义（F38,38=7.653，P=.006；F38,38=13.309，P<.001；F37,37=92.304，P<.001；F37,38=110.675，P<.001；F38,38=10.379，P=.002；F37,37=5.289，P=.02）。
本研究提供的证据表明，基于微信的多学科、全程营养管理方案可显著改善化疗期间 OC 患者的营养状况。
