App for caregivers associated with better quality of life in patients with terminal cancer in China
When added to usual care, the app was associated with improved health-related quality of life for patients after two months, while caregivers said the app helped them identify signs of future outcomes, more accurately report symptoms, and proactively discuss tests, among other benefits.
A palliative care app added to usual care was shown to enhance health-related quality of life for homebound patients with terminal cancer after two months, a study found.
An open-label randomized trial assessed whether providing family caregivers access to the Chinese-based WeChat palliative care educational app was better than usual care for adults with incurable cancer. The app gave family caregivers easy access to nursing information and multimedia education on managing symptoms and adverse effects. Researchers studied data from 147 adult patient-caregiver pairs to determine whether the app could improve health-related quality of life, primarily assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) and secondarily assessed with the Hamilton Anxiety Rating Scale (HAM-A). Patient-caregiver pairs were randomly assigned 1:1 to use the palliative care educational app plus usual palliative care or usual palliative care alone. The study results were published Sept. 23 by Annals of Internal Medicine.
The analysis of the primary outcome included 74 pairs in the intervention group and 73 in the control group. When added to usual care, the app was associated with improved health-related quality of life for patients after two months. The intervention group improved their EORTC QLQ-C30 score, while the control group's EORTC QLQ-C30 score decreased, indicating a moderate improvement in health-related quality of life among the former. At month 2, EORTC QLQ-C30 summary scores were 51.9 (95% CI, 45.4 to 58.5) in the intervention group and 35.7 (95% CI, 28.6 to 42.9) in the control group (mean difference, 16.2; 95% CI, 9.3 to 23.1). A similar effect was seen among both groups in changes to HAM-A scores, indicating that patients in the intervention group improved from significant anxiety at baseline to mild anxiety at month 2. In addition, app analytics showed intensive engagement among family caregivers, and 17 family members who responded to follow-up questions at the end of the trial said the app helped them identify signs of future outcomes, more accurately report symptoms, and proactively discuss tests, among other benefits.
The researchers noted that more study will be needed for wider implementation of the app. The two-month evaluation period is short, and control patients may gain similar skills via prolonged outpatient visits, potentially narrowing group differences over time, they said. Also, the app is widely used in China, but other populations may be less familiar with it or less willing to use it to access information because cultural nuances may affect content interpretation, requiring careful translation, the researchers noted.
“Future studies should aim to validate efficacy in other centers with diverse regional or cultural populations; collect detailed demographic, socioeconomic, and educational data; assess participants' access to other educational resources; and extend follow-up,” the authors wrote. “Further work may explore adaptation of materials to other languages or platforms.”