TY - JOUR

T1 - A randomised controlled trial of a digital intervention (Renewed) to support symptom management, wellbeing and quality of life in cancer survivors

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, Guiqong 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 William Alfred

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, Ella

AU - Yardley, Lucy

PY - 2023/12/20

Y1 - 2023/12/20

N2 - BackgroundMany 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. Pragmatic parallel open randomised trial.Setting. UK general practices.Methods. People having finished primary treatment (<= 10 years previously) for colo-rectal, breast or prostate cancers, with European-Organization-for-Research-and-Treatment-of-Cancer 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, 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 (primary time point: n’s respectively 806;749;705) all groups improved, with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both intervention groups. By 12 months there were: small improvements in EORTC QLQ-C30 for Renewed-with-support (versus generic advice: 1.42, 95% CIs 0.33-2.51); both groups improved global health (12 months: renewed: 3.06, 1.39-4.74; renewed-with-support: 2.78, 1.08-4.48), dyspnoea, constipation, and enablement, and lower NHS costs (generic advice £265: in comparison respectively £141 (153-128) and £77 (90-65) lower); 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 - BackgroundMany 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. Pragmatic parallel open randomised trial.Setting. UK general practices.Methods. People having finished primary treatment (<= 10 years previously) for colo-rectal, breast or prostate cancers, with European-Organization-for-Research-and-Treatment-of-Cancer 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, 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 (primary time point: n’s respectively 806;749;705) all groups improved, with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both intervention groups. By 12 months there were: small improvements in EORTC QLQ-C30 for Renewed-with-support (versus generic advice: 1.42, 95% CIs 0.33-2.51); both groups improved global health (12 months: renewed: 3.06, 1.39-4.74; renewed-with-support: 2.78, 1.08-4.48), dyspnoea, constipation, and enablement, and lower NHS costs (generic advice £265: in comparison respectively £141 (153-128) and £77 (90-65) lower); 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.

U2 - https://doi.org/10.3399/BJGP.2023.0262

DO - https://doi.org/10.3399/BJGP.2023.0262

M3 - Article

JO - British Journal of General Practice

JF - British Journal of General Practice

SN - 0960-1643

ER -