TY - JOUR
T1 - Digital intervention (Renewed) to support symptom management, wellbeing, and quality of life among cancer survivors in primary care: a randomised controlled trial
AU - Little, Paul
AU - Bradbury, Katherine
AU - Stuart, Beth
AU - Barnett, Jane
AU - Krusche, Adele
AU - Steele, Mary
AU - Heber, Elena
AU - Easton, Steph
AU - Smith, Kirsten Ailsa
AU - Slodkowska-Barabasz, Joanna
AU - Payne, Liz
AU - Corbett, Teresa
AU - Yao, Guiqing
AU - Pollet, Sebastien
AU - Smith, Jazzine
AU - Joseph, Judith
AU - Lawrence, Megan
AU - Bohning, Dankmar
AU - Cheetham-Blake, Tara
AU - Eccles, Diana
AU - Foster, Claire
AU - Geraghty, Adam W A
AU - Leydon, Geraldine
AU - Muller, Andre
AU - Neal, Richard
AU - Osborne, Richard
AU - Rathod, Shanaya
AU - Richardson, Alison
AU - Grimmett, Chloe
AU - Sharman, Geoff
AU - Bacon, Roger
AU - Turner, Lesley
AU - Stephens, Richard
AU - Burford, Tamsin
AU - Wilde, Laura
AU - Middleton, Karen
AU - Liddiard, Megan
AU - Rogers, Kirsty
AU - Raftery, James
AU - Zhu, Shihua
AU - Webley, Fran
AU - Griffiths, Gareth
AU - Nutall, Jaqui
AU - Chalder, Trudie
AU - Wilkinson, Clare E
AU - Watson, Eila
AU - Yardley, Lucy
PY - 2023/12/20
Y1 - 2023/12/20
N2 - BackgroundMany cancer survivors following primary treatment have prolonged poor quality of life.AimTo determine the effectiveness of a bespoke digital intervention to support cancer survivors.Design and settingThis was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224).MethodPeople having finished primary treatment (≤10 years previously) for colorectal, breast, or prostate cancers, with European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) score ≤85, were randomised by online software to: 1) detailed ‘generic’ digital NHS support (‘LiveWell’;n= 906); 2) a bespoke complex digital intervention (‘Renewed’;n= 903) addressing symptom management, physical activity, diet, weight loss, and distress; or 3) ‘Renewed with support’ (n= 903): ‘Renewed’ with additional brief email and telephone support.ResultsMixed linear regression provided estimates of the differences between each intervention group and generic advice. At 6 months all groups improved (primary time point:nfor the generic, Renewed groups, and Renewed with support were 806, 749, and 705, respectively), with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both the Renewed groups. By 12 months there were small improvements in EORTC QLQ-C30 for Renewed with support (versus generic advice: 1.42, 95% confidence interval [CI] = 0.33 to 2.51); both Renewed groups improved global health (12 months: Renewed: 3.06, 95% CI = 1.39 to 4.74; Renewed with support: 2.78, 95% CI = 1.08 to 4.48), dyspnoea, constipation and enablement, and lower primary care NHS costs (in comparison with generic advice [£265]: Renewed was −£141 [95% CI = −£153 to–£128] and Renewed with Support was −£77 [95% CI = −£90 to −£65]); and for Renewed with support improvement in several other symptom subscales. No harms were identified.ConclusionCancer survivors’ quality of life improved with detailed generic online support. Robustly developed bespoke digital support provides limited additional short-term benefit, but additional longer-term improvement in global health, enablement, and symptom management, with substantially lower NHS costs.
AB - BackgroundMany cancer survivors following primary treatment have prolonged poor quality of life.AimTo determine the effectiveness of a bespoke digital intervention to support cancer survivors.Design and settingThis was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224).MethodPeople having finished primary treatment (≤10 years previously) for colorectal, breast, or prostate cancers, with European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) score ≤85, were randomised by online software to: 1) detailed ‘generic’ digital NHS support (‘LiveWell’;n= 906); 2) a bespoke complex digital intervention (‘Renewed’;n= 903) addressing symptom management, physical activity, diet, weight loss, and distress; or 3) ‘Renewed with support’ (n= 903): ‘Renewed’ with additional brief email and telephone support.ResultsMixed linear regression provided estimates of the differences between each intervention group and generic advice. At 6 months all groups improved (primary time point:nfor the generic, Renewed groups, and Renewed with support were 806, 749, and 705, respectively), with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both the Renewed groups. By 12 months there were small improvements in EORTC QLQ-C30 for Renewed with support (versus generic advice: 1.42, 95% confidence interval [CI] = 0.33 to 2.51); both Renewed groups improved global health (12 months: Renewed: 3.06, 95% CI = 1.39 to 4.74; Renewed with support: 2.78, 95% CI = 1.08 to 4.48), dyspnoea, constipation and enablement, and lower primary care NHS costs (in comparison with generic advice [£265]: Renewed was −£141 [95% CI = −£153 to–£128] and Renewed with Support was −£77 [95% CI = −£90 to −£65]); and for Renewed with support improvement in several other symptom subscales. No harms were identified.ConclusionCancer survivors’ quality of life improved with detailed generic online support. Robustly developed bespoke digital support provides limited additional short-term benefit, but additional longer-term improvement in global health, enablement, and symptom management, with substantially lower NHS costs.
U2 - 10.3399/BJGP.2023.0262
DO - 10.3399/BJGP.2023.0262
M3 - Article
C2 - 38164562
SN - 0960-1643
VL - 75
SP - e357-e365
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 754
ER -
