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 A
AU - Slodowska-Barabasz, Joanna
AU - Payne, Liz
AU - Corbett, Teresa
AU - Wilde, Laura
AU - Yao, Guiqing Lily
AU - Pollet, Sebastien
AU - Smith, Jazzine
AU - Joseph, Judith
AU - Lawrence, Megan
AU - Böhning, Dankmar
AU - Cheetham-Blake, Tara
AU - Eccles, Diana
AU - Foster, Claire
AU - Geraghty, Adam WA
AU - Leydon, Geraldine
AU - Müller, Andre Matthias
AU - Neal, Richard D
AU - Osborne, Richard
AU - Rathod, Shanaya
AU - Richardson, Alison
AU - Grimmett, Chloe
AU - Sharman, Geoffrey
AU - Bacon, Roger
AU - Turner, Lesley
AU - Stephens, Richard
AU - Rogers, Kirsty
AU - Raftery, James
AU - Zhu, Shihua
AU - Singh, Karmpaul
AU - Webley, Frances
AU - Griffiths, Gareth
AU - Nutall, Jaqui
AU - Chalder, Trudie
AU - Wilkinson, Clare
AU - Watson, Eila
AU - Yardley, Lucy
PY - 2025/1/13
Y1 - 2025/1/13
N2 - Background - Many cancer survivors following primary treatment have prolonged poor quality of life.Aim - To determine the effectiveness of a bespoke digital intervention to support cancer survivors.Design and setting - This was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224).Method - People 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.Results - Mixed linear regression provided estimates of the differences between each intervention group and generic advice. At 6 months all groups improved (primary time point: n for 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.Conclusion - Cancer 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 - Background - Many cancer survivors following primary treatment have prolonged poor quality of life.Aim - To determine the effectiveness of a bespoke digital intervention to support cancer survivors.Design and setting - This was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224).Method - People 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.Results - Mixed linear regression provided estimates of the differences between each intervention group and generic advice. At 6 months all groups improved (primary time point: n for 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.Conclusion - Cancer 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.
KW - cancer survivors
KW - health resources
KW - primary health care
KW - self-management
U2 - 10.3399/BJGP.2023.0262
DO - 10.3399/BJGP.2023.0262
M3 - Article
SN - 0960-1643
JO - British Journal of General Practice
JF - British Journal of General Practice
ER -