Pilot Feasibility Trial of a Supportive Care Digital Application for Patients with Advanced Nonsmall Cell Lung Cancer.

Background

Patients with advanced nonsmall cell lung cancer (NSCLC) experience burdensome symptoms, psychological distress, and poor quality of life (QOL).

Objective

We developed and pilot-tested a digital health application ("THRIVE"), consisting of six modules designed to improve patients' symptom management and coping with NSCLC.

Design

Randomized pilot feasibility trial. Setting/Subjects: Eligible patients included adults within 12 weeks of an advanced NSCLC diagnosis receiving care at a participating institution in the United States. Measurements: Participants completed baseline and 12-week assessments of QOL (Functional Assessment of Cancer Therapy-Lung), physical symptoms (MD Anderson Symptom Inventory; MDASI), psychological distress (Hospital Anxiety and Depression Scale), and coping (Brief COPE). The primary outcome was study feasibility, defined as ≥65% of approached patients consenting to participate; ≥70% of intervention participants completing ≥4 of 6 app modules; and ≥70% of the sample completing the 12-week assessments. We used the System Usability Scale (SUS) to assess intervention acceptability.

Results

Of 232 patients approached, 135 (58.2%) provided consent, and 120 (51.7%) were randomized (Agemean = 67.90 years, 61.7% female, 90.8% White). Among intervention participants, 70.5% (43/61) completed ≥4 modules, with 77.3% reporting above-average SUS usability ratings for THRIVE. Ninety-four (78.3%) participants completed the 12-week assessments.

Conclusions

Although the enrollment rate was lower than anticipated, patients with advanced NSCLC who received THRIVE met the feasibility criterion for app completion and reported high acceptability. These results support conducting a follow-up efficacy trial of THRIVE for improving patients' QOL, physical symptoms, and other psychosocial outcomes.