Marlon Saria, PhD
John Wayne Cancer Institute
CEO Founder of CancerLife
CancerLife announces results of pilot study of its digital therapeutic which showed a 25% improvement of QoL metrics and reduction of symptom burden by 70% with its most active users. Expands study to 1,000 and adds randomization to its virtual clinical trial.
There is no doubt that patients diagnosed with cancer live longer due to advances in immunotherapy and more early detection methods. Cancer and its treatment, however, produce multiple symptoms that significantly distress patients and impair function. Such common symptoms and often go undetected can include fatigue, depressive symptoms, cancer-related pain, and other bodily changes. These symptoms can delay or lead to premature treatment termination, depression, poor quality of life outcomes, and lead to hospitalizations and emergency room visits to manage these symptoms.
Patient reporting of symptoms or patient-reported outcomes (PROs) has been a suggested approach to improve both the control of symptoms and improved quality of Life metrics and even a dramatic improvement in overall survival* (Basch 2017). There are several ways to collect these symptoms (PROs), but none are required as part of the standard of care. Patient portals have attempted to use their electronic communication to capture this data when the patient initiates an engagement. Still, evidence has shown the patients rarely engage on these systems frequently enough to capture enough data to build a comprehensive picture of the patient’s health status. Health systems and cancer centers have responded by piloting remote patient monitoring studies that have initiated engagement from the provider to the patient using text messages and or email communications. ( Basch 2017) Remote patient monitoring systems offer significant benefits and have shown to improve outcomes and lower hospitalizations.
However, remote patient monitoring presents significant workflow disruption to a busy Cancer Center that responds to patient’s needs when needed. Community oncology practices also are limited by the number of resources available to answer to these remote patient monitoring systems and therefore are not practical in real-world community ecology settings.
Our study’s purpose was to show that empowering patients with a digital health platform called Cancerlife, will lead to more effective, longitudinal data collection, thereby improving quality of life metrics. Our platform also solves the particular problem of patient engagement by allowing users to share their health status with other patients, which provides meaningful social support during treatment. It’s this specific social interaction that generates significant emotional reward while at the same time enabling the level of data collection of patient-reported outcomes needed to impact the quality of life outcomes and metrics.
We hypothesized that by empowering patients to collect their data and providing print- out reports that could be shared manually with the patient’s care team, more effective communication and management of symptoms would lead to a higher quality of life scores.
Fundamentally, we asked a simple but essential question: Do patients have the ability to collect their own symptoms and share this data with their care team using a novel digital health solution?
Finally, this study’s key focus was to assess the engagement metrics within the digital health solution Cancerlife focused on the number of times a week, patients shared their health status without being prompted. Also, the number of times patients engaged with other posts, comments and likes similar to other social networks like Facebook, and we also looked for correlations between the number of times patients engaged on the platform and their quality of life scores.
Our goal was to show meaningful improvement in outcomes metrics by using and engaging the CancerLife digital health solution and sharing the data collected with the care team.
We hypothesized that using digital data capture and communication platform can improve quality of life and enhance physician–patient interaction in patients with cancer and their caregivers. Our study showed that CancerLife optimized self-monitoring and reporting of symptoms and showed promise in reducing symptoms in highly engaged participants.
Our study showed that empowering patients by using a digital information and communication platform that could be logged into at any time (24/7) would create similar data collection observations that could present to the care team at the time of consultation without the need for clinical intervention. 78 Patients in our study logged onto CancerLife and posted and shared their health status on average 2.2 times per week for up to 20 weeks. This data highlights the benefits of the digital communication platform showing a reduction in symptom burden in patients diagnosed with cancer. Patient-reported outcomes (PROs) collected longitudinally by the patients are equally effective at lowering symptom burden and improving the patient’s quality of life. For those who were the most active (top 25% of users) on the Cancerlife platform, saw an average improvement in QoL metrics (FACT-G survey) was 24.7 % while reducing their symptom burden by 79%.
In conclusion, these results show the importance of digital communication and improving quality of life and symptom burden using the CancerLife platform. One of the key goals of this study was to prove that cancer care outcomes can be achieved when the patients can collect better data themselves and present their data to the care team at the time of consultation.
Although Remote Patient Monitoring systems have clear benefits, the resource constraints on the care team’s daily workflow make implementing these RPM systems a burden to many health systems or independent offices, especially in the community oncology setting. Our theory has been that the issues with symptom management within cancer care is partly a data collection and sharing problem. Empowering patients with a platform to easily collect and report this data back to care teams without the workflow burden of asynchronous messaging would achieve meaningful outcomes. Ultimately the ideal state in any high burden disease is real-time communication with the patient’s care team and doctor. But in practice, this is highly unrealistic. Even in the most patient-centric practices the cost and burden are incredibly high. CancerLife is designed to empower patients to share this burden in an easy-to-use app that creates reports that are shared manually at the time of face-to-face or online consultation. We believe Cancerlife achieves meaningful outcomes with limited workflow and operations burden on practices and ultimately will be preferred by cancer practices with limited time and resources.
After the study conclusion and analysis, we are expanding our current study protocol and changing the QoL measure to the EQ-5 European scale, which will be better suited to a digital solution like Cancerlife. Furthermore, we add a randomization component to our virtual study and expand to over 1000 participants. We believe that after the results of this randomized control trial, we will be the first and only direct to consumer app that is clinically validated to improve QoL through better patient driven symptom management and engagement.