Supporting Cancer Patients on Their Treatment Journey Towards Self-Efficacy: Usability Pilot Study of a Digital Therapeutic Solution (Preprint)

Abstract

BACKGROUND Digital lifestyle interventions can help cancer survivors better manage their disease through improved lifestyle choices. OBJECTIVE Our aim was to test the feasibility of a digital therapeutic (DTx) program for cancer patients, as measured by engagement, retention, and acceptability. We additionally explored the effects of the program on cancer-related quality of life. METHODS A four-week-long, single-arm trial was conducted in Iceland where the DTx was delivered through a smartphone app. The intervention consisted of completing daily missions (e.g., food logging, activity tracking, surveys) and receiving educational content about mindfulness, sleep, stress, and nutrition. Usage information such as engagement, retention, and step goal attainment, as well as patient-reported outcomes about energy, stress and quality of sleep were collected throughout the study. Cancer-specific quality of life using the EORTC QLQ-C30 questionnaire, as well as cardiovascular fitness and body composition were measured at baseline and follow-up. RESULTS Thirty cancer patients in active treatment were enrolled and 29 registered in the program (79% female, with mean age of 52.6 years, 62% with breast cancer). All 29 participants were active at least three out of four weeks, and 28 (97%) completed the pre- and post- program questionnaires. 72% were highly engaged, the median number of weekly active days were 6.8 (IQR: 5.8, 6.8), and mean daily mission interactions were 7.7 (SD = 1.9). On week one, all 29 participants used the step counter, and 72% reached their step goals; most of these individuals (n = 27) were still using the step counter on week four, with 70% reaching their step goals. The DTx had high acceptability, as 89% of participants said they were likely to recommend it, and 82% said the program helped them deal with the disease. Quality of life (QoL) assessment showed that global health status, functioning and symptom burden remained stable from baseline to follow-up. The largest improvement was observed in pain scores, which decreased from 31 (SD = 20.1) to 22.6 (SD = 23.2) (P= .16). CONCLUSIONS The high retention, engagement and acceptability found in this study demonstrate that a multidisciplinary DTx is feasible for cancer patients. A longer, full-scale randomized controlled trial (RCT) is currently being planned to evaluate the efficacy of the intervention.