Researchers aimed to test the feasibility of a DTx program for patients with cancer, as measured by engagement, retention, and acceptability. In addition, we explored the effects of the program on cancer-related QoL. The high retention, employment, and acceptability found in this study demonstrated that multidisciplinary DTx is feasible for patients with cancer.

The researchers conducted a 4-week single-arm trial in Iceland, where DTx was delivered through a smartphone app. The intervention included patient education about mindfulness, sleep, stress, and nutrition; lifestyle coaching; completing daily missions to track physical activity and exercise; reporting patient-reported outcomes (PROs); practicing mindfulness; and logging healthy food intake. Information on program engagement and retention, step goal attainment, and PROs were collected throughout the study. QoL was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 at baseline and follow-up.

In total, 30 patients with cancer undergoing active therapy were enrolled, and 29 were registered in the app (23 female, 18 with breast cancer; mean age 52.6, SD 11.5 years). Overall, 97% (28/29) of participants were active in 3 of the four weeks and completed the pre- and post-program questionnaires. The weekly busy days (median) were 6.8 (IQR 5.8-6.8), and 72% (21/29) of participants were active at least five days a week. Users interacted with the app on average 7.7 (SD 1.9) times daily. On week 1, all 29 participants used the step counter and logged an average of 20,306 steps; 21 (72%) participants reached their step goals of at least 3000 steps per day. On week 4, of the 28 active users, 27 (96%) were still logging their stations, with 19 (68%) reaching their step goals. Of the 28 participants who completed the satisfaction questionnaire, 25 (89%) were likely to recommend the program, 23 (82%) said the program helped them deal with the disease, and 24 (86%) said it helped them remember their medication. QoL assessment showed that the average global health status, functioning, and symptom burden remained stable from baseline to follow-up. In all, 50% (14/28) of participants reported less pain, and the average pain score decreased from 31 (SD 20.1) to 22.6 (SD 23.2; P=.16). There was no significant change in PROs on the quality of sleep, energy, and stress levels from the first to the last week.

Insights:

I have found that newly diagnosed cancer patients and caregivers are eager for more information about their cancer and treatment options. In research with cancer patients we found they were also interested in other patients’ experiences around nutrition and wellness during treatment.

Several years ago, we tested a CD-ROM given to patients undergoing branded therapy for colorectal cancer. The CD-ROM had interactive features that answered patients’ questions on what to expect and wellness and explained how the treatment worked. Over 95% of patients given the CD-ROM accessed its contents, but the project was terminated because of the lack of ROI.

Newly diagnosed cancer patients are often confused about treatment options and what to expect. Oncologists don’t have the time to answer all their patient’s questions, and when receiving IV treatments, many cancer patients reported that they only interacted with nurses, not their doctors.

There is a need for more information for newly diagnosed patients. Pharma could leverage this need to get closer to patients and to communicate that it’s not just about the money.