Reduced symptom burden with the support of an interactive app during neoadjuvant chemotherapy for breast cancer – A randomized controlled trial

Abstract

Objectives Neoadjuvant chemotherapy causes distressing symptoms, which have to be managed by patients at home. Assessing and acting upon relevant patient-reported symptoms regularly with the support of mHealth such as apps, has shown to decrease symptom burden and improve health-related quality of life (HRQoL). There is a lack of apps for patients with breast cancer which are tested in rigorous trials and only a few include interactive components for immediate clinical management. The aim of this study was to evaluate whether the use of the interactive app Interaktor improves patients’ levels of symptom burden and HRQoL during neoadjuvant chemotherapy for breast cancer. Materials and methods This randomized controlled trial included patients in an intervention group (n = 74) and a control group (n = 75), recruited at two university hospitals in Stockholm, Sweden. The intervention group used Interaktor for symptom reporting, self-care advice and support from health-care professionals during treatment, and the control group received standard care alone. Self-reported symptoms and HRQoL were assessed at two time points to determine differences between the groups. Results The intervention group rated statistically significant less symptom prevalence in nausea, vomiting, feeling sad, appetite loss and constipation. Overall symptom distress and physical symptom distress were rated statistically significant lower in the intervention group. Further, emotional functioning was rated statistically significant higher in the intervention group. Conclusions By using the Interaktor app in clinical practice, patients get individual support when managing treatment-related symptoms during neoadjuvant chemotherapy for breast cancer, leading to decreased symptom burden and improved emotional functioning.

Engagement in an Interactive App for Symptom Self-Management during Treatment in Patients With Breast or Prostate Cancer: Mixed Methods Study

“…As most patients undergoing neoadjuvant chemotherapy for breast cancer or radiotherapy for prostate cancer are treated on an outpatient basis, partially self-reliant management of symptoms is necessary. Several studies show decreased symptom burden [ 24 , 45 ], that patients appreciate using Interaktor, and that they feel secure [ 21 , 26 ]. The app is currently being evaluated in two randomized controlled trials that include patients with breast cancer and prostate cancer, with the hypothesis that using the app will improve symptom management, reduce symptom burden, and increase cost-effectiveness through a reduced consumption of health care services in comparison to standard care alone [ 20 ].…”

“…An understanding of how Interaktor is used and perceived, including the impacts of individual factors, is warranted in order to support the interpretation of the clinical effects of using the app during treatment [ 45 ]. Therefore, this study aimed to describe engagement with the Interaktor app among patients with breast and prostate cancer during their treatment.…”

Checklists for Complications During Systemic Cancer Treatment Shared by Patients, Friends, and Health Care Professionals: Prospective Interventional Cohort Study

“…Many studies did not report on app usage. Only a few studies have reported improvements in quality of life [ 26 , 27 ]. App for monitoring pain and linked to the ability to escalate to a clinician might lead to improved symptom control [ 28 ].…”

From Precision Metapharmacology to Patient Empowerment: Delivery of Self-Care Practices for Epilepsy, Pain, Depression and Cancer Using Digital Health Technologies

“…Diverse non-pharmacological modalities can not only improve fatigue, sleep and HRQoL, but can also strengthen the immune system ( Table 1 ). Digital health technologies for people with cancer include mobile apps for pain relief ( Yang et al, 2019 ), self-management ( Fjell et al, 2020 ; Kim et al, 2018 ), or videogames designed to promote physical exercise and mental empowerment in pediatric oncology patients ( Bruggers et al, 2018 ; Govender et al, 2015 ). Personalized digital interventions for oncology patients can provide diverse self-care modalities such as physical exercises, yoga, mindfulness meditations, and breathing exercises ( Supplementary Table S3 ).…”