Skip to main content

Advertisement

SpringerLink
Log in

A single-site pilot feasibility randomized trial of a supportive care mobile application intervention for patients with advanced cancer and caregivers

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

Mobile health interventions can improve patient care. We developed the Digital Supportive Care Awareness and Navigation (D-SCAN) application (app) to facilitate symptom monitoring and use/awareness of cancer supportive care resources. This study tested feasibility, usability/satisfaction, and preliminary efficacy of D-SCAN.

Methods

We randomized 50 patients with advanced cancer to receive the D-SCAN intervention or usual care; 10 caregivers also received D-SCAN. The primary feasibility outcome was determined by weekly symptom survey completion and end of study procedures. We assessed secondary outcomes including usability/satisfaction, awareness/use of supportive care resources, patient activation, and quality of life via various questionnaires including the Net Promoter Score (NPS), Patient Activation Measure (PAM-13), Functional Assessment of Cancer Therapy-General (FACT-G), and Caregiver Oncology Quality of Life (CarGOQOL) questionnaire.

Results

Seventy-six percent of intervention patients met feasibility criteria, exceeding our pre-determined threshold of 75%. Usability/satisfaction by NPS was high, at 14.3% and 12.5% for patients and caregivers, respectively. Intervention patient and caregiver resource awareness increased by a mean of 3.7 (p = 0.27) and 4.1 items, respectively. Supportive care resource utilization increased by a mean of 0.8 items for intervention patients (p = 0.70) and 0.6 for caregivers. PAM-13 increased by a mean of 1.6 for intervention patients (p = 0.65). FACT-G increased by a mean of 1.1 for intervention patients (p = 0.91), and CarGOQoL increased by a mean of 2.2 (p = 0.41).

Conclusion

D-SCAN is a feasible, usable, and satisfactory intervention for augmenting patient and caregiver supportive care. Further testing is necessary to formally assess D-SCAN’s efficacy and impact on patients and caregivers.

Clinical trial registration number. NCT03628794. Registered on August 14th, 2018.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data has not been deposited to any central repository but can be made available upon request.

Code availability

All analyses were done using SAS v9.4 (SAS Institute, Cary, NC). Code can be made available upon request.

References

  1. Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D (2017) Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA 318:197. https://doi.org/10.1001/jama.2017.7156

    Article  PubMed  PubMed Central  Google Scholar 

  2. Absolom K, Warrington L, Hudson E, Hewison J, Morris C, Holch P, Carter R, Gibson A, Holmes M, Clayton B, Rogers Z, McParland L, Conner M, Glidewell L, Woroncow B, Dawkins B, Dickinson S, Hulme C, Brown J, Velikova G (2021) Phase III randomized controlled trial of eRAPID: eHealth intervention during chemotherapy. JCO 39:734–747. https://doi.org/10.1200/JCO.20.02015

    Article  CAS  Google Scholar 

  3. Maguire R, McCann L, Kotronoulas G, Kearney N, Ream E, Armes J, Patiraki E, Furlong E, Fox P, Gaiger A, McCrone P, Berg G, Miaskowski C, Cardone A, Orr D, Flowerday A, Katsaragakis S, Darley A, Lubowitzki S, Harris J, Skene S, Miller M, Moore M, Lewis L, DeSouza N, Donnan PT (2021) Real time remote symptom monitoring during chemotherapy for cancer: Eur Multicentre Randomised Control Trial (eSMART). BMJ n1647. https://doi.org/10.1136/bmj.n1647

  4. Howell D, Li M, Sutradhar R, Gu S, Iqbal J, O’Brien MA, Seow H, Dudgeon D, Atzema C, Earle CC, DeAngelis C, Sussman J, Barbera L (2020) Integration of patient-reported outcomes (PROs) for personalized symptom management in “real-world” oncology practices: a population-based cohort comparison study of impact on healthcare utilization. Support Care Cancer 28:4933–4942. https://doi.org/10.1007/s00520-020-05313-3

    Article  PubMed  Google Scholar 

  5. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG (2009) Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 42:377–381. https://doi.org/10.1016/j.jbi.2008.08.010

    Article  PubMed  Google Scholar 

  6. Watanabe SM, Nekolaichuk C, Beaumont C, Johnson L, Myers J, Strasser F (2011) A multicenter study comparing two numerical versions of the Edmonton symptom assessment system in palliative care patients. J Pain Symptom Manage 41:456–468. https://doi.org/10.1016/j.jpainsymman.2010.04.020

    Article  PubMed  Google Scholar 

  7. Reichheld FF (2003) The one number you need to grow. Harv Bus Rev 81(46–54):124

    Google Scholar 

  8. Hibbard JH, Mahoney ER, Stockard J, Tusler M (2005) Development and testing of a short form of the patient activation measure. Health Serv Res 40:1918–1930. https://doi.org/10.1111/j.1475-6773.2005.00438.x

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. JCO 11:570–579. https://doi.org/10.1200/JCO.1993.11.3.570

    Article  CAS  Google Scholar 

  10. Obeid JS, McGraw CA, Minor BL, Conde JG, Pawluk R, Lin M, Wang J, Banks SR, Hemphill SA, Taylor R, Harris PA (2013) Procurement of shared data instruments for Research Electronic Data Capture (REDCap). J Biomed Inform 46:259–265. https://doi.org/10.1016/j.jbi.2012.10.006

    Article  CAS  PubMed  Google Scholar 

  11. Minaya P, Baumstarck K, Berbis J, Goncalves A, Barlesi F, Michel G, Salas S, Chinot O, Grob J-J, Seitz JF, Bladou F, Clement A, Mancini J, Simeoni M-C, Auquier P (2012) The CareGiver Oncology Quality of Life questionnaire (CarGOQoL): development and validation of an instrument to measure the quality of life of the caregivers of patients with cancer. Eur J Cancer 48:904–911. https://doi.org/10.1016/j.ejca.2011.09.010

    Article  PubMed  Google Scholar 

  12. Carlbring P, Maurin L, Törngren C, Linna E, Eriksson T, Sparthan E, Strååt M, Marquez von Hage C, Bergman-Nordgren L, Andersson G (2011) Individually-tailored, Internet-based treatment for anxiety disorders: a randomized controlled trial. Behav Res Ther 49:18–24. https://doi.org/10.1016/j.brat.2010.10.002

    Article  PubMed  Google Scholar 

  13. Young-Afat DA, van Gils CH, Bruinvels DJ, van der Pol CC, Witkamp AJ, Sijtsema S, Jonasse Y, Bijlsma RM, Ausems MG, Bos AM, van den Bongard DH, Verkooijen HM (2016) Patients’ and health care providers’ opinions on a supportive health app during breast cancer treatment: a qualitative evaluation. JMIR Cancer 2:e8. https://doi.org/10.2196/cancer.5334

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We acknowledge Publicis Health for their work developing the D-SCAN mobile application. TLB and CM are currently employed by GlaxoSmithKline. We are thankful to the patients and families/caregivers who participated in this research.

Funding

This study was funded in part by AstraZeneca via a grant to the Duke Cancer Institute.

Author information

Authors and Affiliations

  1. Duke University, Durham, NC, 27710, USA

    Alexandra Merz

  2. Duke University School of Medicine, Durham, NC, 27710, USA

    Amro Mohamed & Jordan Hildenbrand

  3. Duke Cancer Institute, Durham, NC, 27710, USA

    Cheyenne Corbett, Kris Herring, Susan C. Locke, Steven Patierno, S. Yousuf Zafar & Thomas W. LeBlanc

  4. Division of Biostatistics, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, 27710, USA

    Jesse Troy & Steven Wolf

  5. AstraZeneca, Wilmington, DE, 19803, USA

    Jack Chilcott, Adam Higgins, Colette McCoy & Trudy L. Buckingham

  6. Publicis Sapient, Cambridge, MA, USA

    Hugo Manassei

  7. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University School of Medicine, Box 2715, Durham, NC, 27710, USA

    Thomas W. LeBlanc

Authors
  1. Alexandra Merz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Amro Mohamed
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cheyenne Corbett
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kris Herring
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jordan Hildenbrand
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Susan C. Locke
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Steven Patierno
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Jesse Troy
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Steven Wolf
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S. Yousuf Zafar
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jack Chilcott
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Adam Higgins
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Hugo Manassei
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Colette McCoy
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Trudy L. Buckingham
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Thomas W. LeBlanc
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: JC, CC, KH, AH, TWL, HM, CM, SP, TLB, SYZ.

Material preparation, data collection, and analysis: all authors.

Original draft: AM, AM, TWL.

Manuscript revision: all authors.

Funding acquisition: SP, TLW.

Corresponding author

Correspondence to Thomas W. LeBlanc.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the Duke University School of Medicine (PRO00092123).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

Patients signed informed consent to participate in the study, which includes publishing deidentified data.

Conflict of interest

Researchers declare the following conflicts of interest: TWL reports personal fees for consulting or advisory boards from AbbVie, Agios/Servier, AstraZeneca, Astellas, CareVive, BMS/Celgene, Genentech, GSK, Pfizer, and Seattle Genetics; royalties from UpToDate; speakers bureau fees from Agios, AbbVie, and BMS/Celgene; grants and/or research contracts from the American Cancer Society, AstraZeneca, BMS, Jazz Pharmaceuticals, the NINR/NIH, and Seattle Genetics.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Below is the link to the electronic supplementary material.

Supplementary file1 (PDF 44 KB)

Supplementary file2 (DOCX 31 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Merz, A., Mohamed, A., Corbett, C. et al. A single-site pilot feasibility randomized trial of a supportive care mobile application intervention for patients with advanced cancer and caregivers. Support Care Cancer 30, 7853–7861 (2022). https://doi.org/10.1007/s00520-022-07224-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-022-07224-x

Keywords

Search

Navigation