DISCUSSIONS
cancer
CANCER
This study used a randomized controlled trial to evaluate the efficacy and usability of an app (LivingWith®) that provides self‐management support for patients with cancer undergoing chemotherapy on health care utilization and quality of life. The findings demonstrate a positive impact of the intervention in reducing the number of office visits utilized and an encouraging trend in fewer visits with a mental health provider. There were no significant changes by study groups in quality of life, use of virtual care, or emergency room and urgent care visits.Patients with cancer undergoing chemotherapy must manage an overwhelming amount of information to coordinate their treatment and related activities. Comprehensive coordinating efforts are needed to manage complex schedules and side‐effects of chemotherapy treatments. Our findings showed similar reported app use across sociodemographic subgroups, with slightly higher use among participants who identified as Black or had lower incomes (eTable Apps can be leveraged by patients to support their efforts to manage their health, coordinate appointments, and keep track of treatment notes and questions.Most intervention participants reported using the app and used it weekly during the 3‐month intervention. Notably, nearly a quarter of intervention participants who consented to participating in this app‐based study reported not even trying the app. Common barriers to using the app included personal preference to communicate with friends and family directly, usability challenges, and privacy concerns. Similarly, previous studies have found that usability was a challenge, especially for a diverse group of patients.This is the first prospectively randomized trial of an app designed to support individuals dealing with cancer with tools to support self‐management activities that shows fewer office visits and no adverse impact on quality of life or urgent care among intervention participants relative to controls. Notably, adjusted results showed a larger reduction in health care utilization for all in‐person services (office visits, mental health, emergency or urgent care) among the intervention group relative to controls, however, the difference only reached statistical significance for office visits (Table Despite its strengths, including the rigorous randomized study design, the novelty of the research, and the diverse sample of patients, this study has limitations. First, participants were recruited from a single cancer center located in the mid‐South region of the United States and the study was limited to English speakers. Findings may not be generalizable to other regions of the country, other cancer centers, and non‐English speakers. Second, intervention group participants were asked to download the study app and use it weekly when consenting to participate in the study, but app use was not enforced, and nearly 1 in 4 reported not using the app. Moreover, it's possible that participants in both groups used other apps to support their health during the study. Lastly, the study only followed participants for a short time, 3 months, and relied on self‐reported data for study outcomes.