A Smart Self-Management Support Programme (3S) to Improve Quality of Life in Lung Cancer Patients

A Smart Self-Management Support Programme (3S) to Improve Quality of Life in Patients With Lung Cancer - A Pragmatic Randomized Controlled Trial With Mixed-method Evaluation

Lung cancers patients often experience multiple symptoms (e.g. fatigue, dyspnea, distress, depression, sleep disturbance). The current study attempts to explore the efficacy of the Smart Self-Management Support Programme (3S) in improving quality of life of patients using self-management support programme with mobile devices.

Lung cancer (LC) is the most and second most common cancer globally and locally respectively. LC patients often experience multiple symptoms (e.g. fatigue, dyspnea, distress, depression, sleep disturbance). The symptom burden is greater than other cancers and adversely affects quality of life. Care of LC patients has shifted from a purely disease-centered approach on survival-related outcomes to person-centered approach with emphasis on quality-of-life outcomes.

Self-management support programme (SMS) is perceived to supplement regular medical treatments and follow-up and cost-effective in cancer care. Besides, digital technologies have been used in patient empowerment digital platform to improve self-management of cancer patients. Using the self-management support programme and mobile devices, the Smart Self-Management Support Programme (3S) attempts to improve quality of life of patients.

The current study aims to examine the efficacy of 3S on improving quality of life and patient activation (knowledge, skills, and confidence for self-management) in the 3S intervention group, compared to the general health (GH) control group. It also aims to examine the changes in the burden of care, anxiety and depression symptoms, and quality of life of the family caregivers (FCGs) of the patients in the 3S group, compared to FCGs of the patients in the GH group.

We also conduct process valuations to assess the essential features of context, implementation, and impact mechanism, and cost-effectiveness evaluation to examine health care resource utilisation and cost-effectiveness analysis.

160 patients with lung cancer will be recruited, and 160 family caregivers will also be invited to join the study.

Patients:

Inclusion Criteria:

• Aged 18 years or above
• Diagnosis of advanced-stage (stage III or stage IV) non-small cell lung cancer
• Ambulatory and capable of all self-care activities (ECOG ≤2)
• Either undergoing or has finished oncology therapy
• Mentally, cognitively and physically fit to join as determined by the doctor in charge and responsible clinical investigators
• Can speak and read Chinese
• Willing to complete the patient-reported outcome questionnaire
• Has a smartphone with WhatsApp or WeChat

Exclusion Criteria:

• Preparing for lung operation
• Skeletal fragility
• Serious active infection
• Inability to walk
• Previously untreated symptomatic brain metastases
• Severe respiratory insufficiency
• Uncontrolled pain
• Diagnosed psychiatric illness with or without medication

Family Caregivers:

Inclusion criteria:

• Aged 18 years or above
• Family caregivers of recruited patients

Exclusion criteria:

• Unable to speak and read Chinese
• Unwilling to complete the patient-reported outcome questionnaire