Effectiveness of a multidomain mHealth-based intervention in enhancing recovery and quality of life for esophageal cancer patients undergoing esophagectomy.

Abstract

4071 Background: Esophagectomy, a primary treatment for esophageal cancer (EC), often compromises patients' quality of life (QOL), leading to malnutrition, reduced physical function, and psychological distress. Multidomain mHealth-based interventions, which leverage technology to deliver comprehensive nutritional, physical, and psychological support, offer a promising approach to address these challenges during prehabilitation and Enhanced Recovery After Surgery (ERAS) phases. Despite their potential, high-quality evidence demonstrating their effectiveness remains limited. This study evaluates the effectiveness of a multidomain mHealth intervention on QOL and recovery outcomes in EC patients undergoing esophagectomy. Methods: Between April 27, 2021 and June 30, 2023, this single-center, randomized controlled trial was conducted, enrolling 76 patients with pathologically confirmed EC scheduled for esophagectomy. Participants were randomized to either a multidomain mHealth-based intervention group (n = 38) or a usual care group (n = 38). The intervention delivered tailored nutritional, physical, and psychological support via a self-developed WeChat-based management platform, spanning from 2 weeks pre-admission to 11 weeks post-discharge. The primary outcome was the change in QOL, assessed using the EORTC QLQ-C30 and QLQ-OES-18. Secondary outcomes included changes in nutritional status (e.g., weight), physical fitness (e.g., 6-minute walk distance), and psychological health (e.g., PHQ-9, GAD-7, SCSQ-20). Outcomes were assessed at baseline, hospital admission, and 3 and 11 weeks post-discharge. Results: At 11 weeks post-discharge, the intervention group showed a significant improvement in QOL, with a 15.56-point increase in Global Health Status (EORTC QLQ-C30) compared to a 5.91-point decline in the usual care group (difference: 21.47 points; 95% CI: 9.86–33.08; p < 0.001). Functional and symptom scores, including social functioning, appetite, and eating, improved markedly in the intervention group. The intervention group also demonstrated superior outcomes in weight change (+2.19 kg; 95% CI: 0.09–4.30; p = 0.041) and 6-minute walk distance (+80.65 meters; 95% CI: 41.64–119.66; p < 0.001). Psychological well-being improved significantly, with reductions in PHQ-9 (-4.70; 95% CI: -6.59 to -2.80; p < 0.001) and GAD-7 (-4.63; 95% CI: -6.52 to -2.74; p < 0.001), and an increase in positive coping scores (+11.83; 95% CI: 7.20–16.45; p < 0.001). Conclusions: This multidomain mHealth intervention significantly enhanced QOL, nutritional and physical outcomes, and psychological health in EC patients undergoing esophagectomy. These findings underscore the potential of mHealth platforms to optimize prehabilitation and recovery, offering a scalable and impactful approach to improving outcomes in oncology care. Clinical trial information: ChiCTR2100045650 .