RESUMO
BACKGROUND: Increasing evidence shows that lifestyle interventions can improve the symptoms, quality of life (QoL), and even overall survival of patients with cancer. Digital therapeutics (DTx) can help implement behavioral modifications and empower patients through education, lifestyle support, and remote symptom monitoring. OBJECTIVE: We 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. METHODS: We conducted a 4-week single-arm trial in Iceland, where DTx was delivered through a smartphone app. The intervention consisted of patient education about mindfulness, sleep, stress, and nutrition; lifestyle coaching; and the completion of daily missions for tracking 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, as well as 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. RESULTS: In total, 30 patients with cancer undergoing active therapy were enrolled, and 29 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 4 weeks and completed the pre- and postprogram questionnaires. The weekly active days (median) were 6.8 (IQR 5.8-6.8), and 72% (21/29) of participants were active at least 5 days a week. Users interacted with the app on average 7.7 (SD 1.9) times per day. 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 steps, 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. CONCLUSIONS: The high retention, engagement, and acceptability found in this study demonstrate that multidisciplinary DTx is feasible for patients with cancer. A longer, full-scale randomized controlled trial is currently being planned to evaluate the efficacy of the intervention.
RESUMO
INTRODUCTION: Five-year survival of people diagnosed with cancer has increased in past decades. Knowledge of the long-term effects of cancer treatment on fitness, body composition and health related quality of life (HR-QoL) is important for cancer patients. The study aimed to evaluate body composition, HR-QoL and personality D of people post cancer treatment in the last 10 years; and to observe whether fitness was correlated with body composition and HR-QoL amongst them. MATERIAL AND METHODS: Eighty participants 25 - 77 y/o of both genders in remission from cancer answered questionnaires on HR-QoL (SF-36v2 and EQ-5D-3L), personality D (DS14), general health, lifestyle and cancer treatment. Participants had their blood pressure measured, conducted the 6-minute walk test (6MWT) and had their body composition meas-ured: body mass index, body fat percentage, waist and hip circumferences. SPSS was used for statistical analysis. RESULTS: Approximately 2/3 of the participants had body composition over recommended values. Over half were overweight or obese. 66.3% had waist circumference over recommended values and 45.0% had waist/hip ratio over recommended values. 6MWT average distance was 634 m +/- 83 m. Significant correlation (p<0.05) was found between 6MWT and body composition and most categories of HR-QoL. -Increased fitness correlated with better body composition and higher HR-QoL. Only 13.8% of participants showed personality D. CONCLUSION: Cancer survivor's body composition is generally not at its best. It is important that people diagnosed with cancer are informed on the importance of healthy body composition. Fitness is an indicator for HR-QoL and body composition of cancer survivors.
