Quality of Life of Women After a First Diagnosis of Breast Cancer Using a Self-Management Support mHealth App in Taiwan: Randomized Controlled Trial

Abstract

Background There are over 2 million newly diagnosed patients with breast cancer worldwide with more than 10,000 cases in Taiwan each year. During 2017-2018, the National Yang-Ming University, the Taiwan University of Science and Technology, and the Taiwan Breast Cancer Prevention Foundation collaborated to develop a breast cancer self-management support (BCSMS) mHealth app for Taiwanese women with breast cancer. Objective The aim of this study was to investigate the quality of life (QoL) of women with breast cancer in Taiwan after using the BCSMS app. Methods After receiving a first diagnosis of breast cancer, women with stage 0 to III breast cancer, who were recruited from social networking sites or referred by their oncologists or oncology case managers, were randomized 1:1 into intervention and control groups. Intervention group subjects used the BCSMS app and the control group subjects received usual care. Two questionnaires—the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire Core 30 (QLQ-C30) and the EORTC Breast Cancer-Specific Quality-of-Life Questionnaire (QLQ-BR23)—were distributed to subjects in both arms. Paper-based questionnaires were used at baseline; paper-based or Web-based questionnaires were used at 1.5-month and 3-month follow-up evaluations. All evaluations were self-assessed and anonymous, and participants were blinded to their allocation groups. Descriptive analysis, the Pearson chi-square test, analysis of variance, and the generalized estimating equation were used to analyze the data. Missing values, with and without multi-imputation techniques, were used for sensitivity analysis. Results A total of 112 women were enrolled and randomly allocated to either the experimental group (n=53) or control group (n=59). The follow-up completion rate was 89.3% (100/112). The demographic data showed homogeneity between the two groups in age (range 50-64 years), breast cancer stage (stage II), marital status (married), working status (employed), and treatment status (receiving treatments). The mean total QoL summary scores from the QLQ-C30 (83.45 vs 82.23, P=.03) and the QLQ-BR23 (65.53 vs 63.13, P=.04) were significantly higher among the experimental group versus the control group, respectively, at 3 months. Conclusions This research provides support for using a mobile health care app to promote the QoL among women in Taiwan after a first diagnosis of breast cancer. The BCSMS app could be used to support disease self-management, and further evaluation of whether QoL is sustained is warranted. Trial Registration ClinicalTrials.gov NCT004174248; https://clinicaltrials.gov/ct2/show/NCT04174248

Efficacy of Mobile Phone Technology for Managing Side Effects Associated with Chemotherapy among Cancer Patients: A Systematic Review and Meta-Analysis

“…A total of 10 trials were included for narrative synthesis that showed a significant decrease in symptoms/side effects and improved quality of life in the interventional group than in the comparison group. 11 13 20 21 22 23 24 25 26 27…”

Effect of mHealth interventions on psychological issues experienced by women diagnosed with breast cancer receiving chemotherapy: A systematic review and meta-analysis

“…Also, another review on the effects of psychoeducational interventions on gynaecological cancer patients and concluded that nurses were the ideal providers of psychoeducational interventions as they facilitated better outcomes following the interventions [58]. As most of the studies in this review were psychoeducational interventions [49][50][51][52][53][54], we infer that nurses have a pivotal is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…None of the studies blinded the intervention providers as they were fully involved in the process and blinding was not feasible. The outcome assessors were not blinded in eight of the studies Only one of the studies blinded the participants [49]. Overall, the studies had low to moderate methodological quality.…”

“…With respect to the time frame, the interventions could be accessed either anytime during the day [48, 49,53,54]; from 8 am to 4 pm daily [47]; for 90 minutes daily [52]; for more than 30 minutes daily [51]; or through a 15-20 minute-long call twice a week [50]; or through is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…[47][48][49][50][51][54][55][56]. Allocation concealment was not done in seven of the studies[48][49][50][51][54][55][56].…”