Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 29, 2020
Date Accepted: Jun 25, 2020
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Development and feasibility of an mHealth supported comprehensive intervention model (“CIMmH”) for improving the quality of life in esophageal cancer patients after esophagectomy: Pilot study
ABSTRACT
Background:
Esophageal cancer patients often experience a clinically relevant deterioration of quality of life (QOL) after esophagectomy due to malnutrition, lack of physical exercise, and psychological symptoms.
Objective:
This study aims to evaluate the feasibility, safety, and efficacy of a comprehensive intervention model using an mHealth system (CIMmH) to esophageal cancer patients after esophagectomy.
Methods:
Twenty esophageal cancer patients undergoing modified McKeown surgery were invited to join the CIMmH with both online and offline components for 12 weeks. The participants were assessed before surgery and again at 1- and 3-month after esophagectomy. Quality of life, depressive symptoms, anxiety, stress, nutrition, and physical fitness were measured.
Results:
Sixteen out of 20 (80%) completed the program. One month after esophagectomy, patients had a significant deterioration in the overall QOL (P = .02), eating (P = .005), reflux (P = .04), and trouble with talking (P < .001). At the 3-month follow-up, except for pain (P = .02), difficulty with eating (P = .03), dry mouth (P = .04), and trouble with talking (P = .003), all other dimensions in the QOL returned to the preoperative level. Weight (P < .001) and BMI (P = .02) were reduced throughout the study and no significant changes were observed in physical fitness. Depressive symptoms significantly increased one month after surgery(P＜.001), while other psychological measures did not change significantly. Though there was a decline in many measures 1 month after surgery, these were much improved at the 3-month visit and this recovery is more profound and faster than with traditional rehabilitation programs.
Conclusions:
The CIMmH was feasible and safe and demonstrated encouraging preliminary efficacy for enhancing recovery after surgery among esophageal cancer patients in China. Clinical Trial: Chinese Clinical Trial Registry (ChiCTR-IPR-1800019900). http://www.chictr.org.cn/.
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