The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most?

A. van der Hout; K. Holtmaat; F. Jansen; B. Lissenberg-Witte; C. F. Van Uden-Kraan; G. A. P. Nieuwenhuijzen; J. A. Hardillo; R. J. Baatenburg de Jong; N. L. Tiren-Verbeet; D. W. Sommeijer; K. de Heer; C. G. Schaar; R. J. E. Sedee; K. Bosscha; M. W. M. van den Brekel; F. Petersen; M. Westerman; J. Honings; R. P. Takes; null Houtenbos; W. T. van den Broek; R. de Bree; P. Jansen; S. E. J. Eerenstein; C. R. Leemans; J. M. Zijlstra; P. Cuijpersa; L. V. Van De Poll-Franse; I. M. Verdonck-de Leeuw

doi:10.1080/0284186X.2020.1851764

The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most?

A. van der Hout, K. Holtmaat, F. Jansen, B. Lissenberg-Witte, C. F. Van Uden-Kraan, G. A. P. Nieuwenhuijzen, J. A. Hardillo, R. J. Baatenburg de Jong, N. L. Tiren-Verbeet, D. W. Sommeijer, K. de Heer, C. G. Schaar, R. J. E. Sedee, K. Bosscha, M. W. M. van den Brekel, F. Petersen, M. Westerman, J. Honings, R. P. Takes, HoutenbosW. T. van den Broek, R. de Bree, P. Jansen, S. E. J. Eerenstein, C. R. Leemans, J. M. Zijlstra, P. Cuijpersa, L. V. Van De Poll-Franse, I. M. Verdonck-de Leeuw^*

^*Corresponding author for this work

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Abstract

Background

Oncokompas is a web-based self-management application that supports cancer survivors to monitor their health-related quality of life (HRQOL) and symptoms, and to obtain personalised feedback and tailored options for supportive care. In a large randomised controlled trial among survivors of head and neck cancer, colorectal cancer, and breast cancer and (non-)Hodgkin lymphoma, Oncokompas proved to improve HRQOL, and to reduce several tumour-specific symptoms. Effect sizes were however small, and no effect was observed on the primary outcome patient activation. Therefore, this study aims to explore which subgroups of cancer survivors may especially benefit from Oncokompas.

Materials and methods

Cancer survivors (n = 625) were randomly assigned to the intervention group (access to Oncokompas, n = 320) or control group (6 months waiting list, n = 305). Outcome measures were HRQOL, tumour-specific symptoms, and patient activation. Potential moderators included socio-demographic (sex, age, marital status, education, employment), clinical (tumour type, stage, time since diagnosis, treatment modality, comorbidities), and personal factors (self-efficacy, personal control, health literacy, Internet use), and patient activation, mental adjustment to cancer, HRQOL, symptoms, and need for supportive care, measured at baseline. Linear mixed models were performed to investigate potential moderators.

Results

The intervention effect on HRQOL was the largest among cancer survivors with low to moderate self-efficacy, and among those with high personal control and those with high health literacy scores. Cancer survivors with higher baseline symptom scores benefitted more on head and neck (pain in the mouth, social eating, swallowing, coughing, trismus), and colorectal cancer (weight) specific symptoms.

Discussion

Oncokompas seems most effective in reducing symptoms in head and neck cancer and colorectal cancer survivors who report a higher burden of tumour-specific symptoms. Oncokompas seems most effective in improving HRQOL in cancer survivors with lower self-efficacy, and in cancer survivors with higher personal control, and higher health literacy.

Original language	English
Pages (from-to)	403-411
Journal	Acta Oncologica
Volume	60
Issue number	4
DOIs	https://doi.org/10.1080/0284186X.2020.1851764
Publication status	Published - 2021

Keywords

Supportive care
eHealth
self-management
health-related quality of life
cancer survivorship
moderators

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10.1080/0284186X.2020.1851764Licence: CC BY-NC-ND

MCP vd Poll Franse the eHealth self management application Oncokompas AO 2021Final published version, 3.44 MBLicence: CC BY-NC-ND

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van der Hout, A., Holtmaat, K., Jansen, F., Lissenberg-Witte, B., Van Uden-Kraan, C. F., Nieuwenhuijzen, G. A. P., Hardillo, J. A., de Jong, R. J. B., Tiren-Verbeet, N. L., Sommeijer, D. W., de Heer, K., Schaar, C. G., Sedee, R. J. E., Bosscha, K., van den Brekel, M. W. M., Petersen, F., Westerman, M., Honings, J., Takes, R. P., ... Verdonck-de Leeuw, I. M. (2021). The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most? Acta Oncologica, 60(4), 403-411. https://doi.org/10.1080/0284186X.2020.1851764

@article{368eca80e022449fa169b177515dd0ff,

title = "The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most?",

abstract = "BackgroundOncokompas is a web-based self-management application that supports cancer survivors to monitor their health-related quality of life (HRQOL) and symptoms, and to obtain personalised feedback and tailored options for supportive care. In a large randomised controlled trial among survivors of head and neck cancer, colorectal cancer, and breast cancer and (non-)Hodgkin lymphoma, Oncokompas proved to improve HRQOL, and to reduce several tumour-specific symptoms. Effect sizes were however small, and no effect was observed on the primary outcome patient activation. Therefore, this study aims to explore which subgroups of cancer survivors may especially benefit from Oncokompas.Materials and methodsCancer survivors (n = 625) were randomly assigned to the intervention group (access to Oncokompas, n = 320) or control group (6 months waiting list, n = 305). Outcome measures were HRQOL, tumour-specific symptoms, and patient activation. Potential moderators included socio-demographic (sex, age, marital status, education, employment), clinical (tumour type, stage, time since diagnosis, treatment modality, comorbidities), and personal factors (self-efficacy, personal control, health literacy, Internet use), and patient activation, mental adjustment to cancer, HRQOL, symptoms, and need for supportive care, measured at baseline. Linear mixed models were performed to investigate potential moderators.ResultsThe intervention effect on HRQOL was the largest among cancer survivors with low to moderate self-efficacy, and among those with high personal control and those with high health literacy scores. Cancer survivors with higher baseline symptom scores benefitted more on head and neck (pain in the mouth, social eating, swallowing, coughing, trismus), and colorectal cancer (weight) specific symptoms.DiscussionOncokompas seems most effective in reducing symptoms in head and neck cancer and colorectal cancer survivors who report a higher burden of tumour-specific symptoms. Oncokompas seems most effective in improving HRQOL in cancer survivors with lower self-efficacy, and in cancer survivors with higher personal control, and higher health literacy.",

keywords = "Supportive care, eHealth, self-management, health-related quality of life, cancer survivorship, moderators",

author = "{van der Hout}, A. and K. Holtmaat and F. Jansen and B. Lissenberg-Witte and {Van Uden-Kraan}, {C. F.} and Nieuwenhuijzen, {G. A. P.} and Hardillo, {J. A.} and {de Jong}, {R. J. Baatenburg} and Tiren-Verbeet, {N. L.} and Sommeijer, {D. W.} and {de Heer}, K. and Schaar, {C. G.} and Sedee, {R. J. E.} and K. Bosscha and {van den Brekel}, {M. W. M.} and F. Petersen and M. Westerman and J. Honings and Takes, {R. P.} and Houtenbos and {van den Broek}, {W. T.} and {de Bree}, R. and P. Jansen and Eerenstein, {S. E. J.} and Leemans, {C. R.} and Zijlstra, {J. M.} and P. Cuijpersa and {Van De Poll-Franse}, {L. V.} and {Verdonck-de Leeuw}, {I. M.}",

note = "I. M. V.-d. L. has received grants from the Dutch Cancer Society (KWF Kankerbestrijding), Pink Ribbon, the Netherlands Organisation for Health Research and Development (ZonMW), the SAG Foundation–Zilveren Kruis Health Care Assurance Company, Danone Ecofund–Nutricia, Red-kite (distributor of eHealth tools), and Bristol-Myers Squibb, during the conduct of this study. C. R. L. has received personal fees for global advisory board participation from MSD, during the conduct of this study. All other authors report no conflicts of interest.",

year = "2021",

doi = "10.1080/0284186X.2020.1851764",

language = "English",

volume = "60",

pages = "403--411",

journal = "Acta Oncologica",

issn = "0284-186X",

publisher = "TAYLOR & FRANCIS LTD",

number = "4",

}

van der Hout, A, Holtmaat, K, Jansen, F, Lissenberg-Witte, B, Van Uden-Kraan, CF, Nieuwenhuijzen, GAP, Hardillo, JA, de Jong, RJB, Tiren-Verbeet, NL, Sommeijer, DW, de Heer, K, Schaar, CG, Sedee, RJE, Bosscha, K, van den Brekel, MWM, Petersen, F, Westerman, M, Honings, J, Takes, RP, Houtenbos, van den Broek, WT, de Bree, R, Jansen, P, Eerenstein, SEJ, Leemans, CR, Zijlstra, JM, Cuijpersa, P, Van De Poll-Franse, LV & Verdonck-de Leeuw, IM 2021, 'The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most?', Acta Oncologica, vol. 60, no. 4, pp. 403-411. https://doi.org/10.1080/0284186X.2020.1851764

TY - JOUR

T1 - The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms

T2 - Which groups benefit most?

AU - van der Hout, A.

AU - Holtmaat, K.

AU - Jansen, F.

AU - Lissenberg-Witte, B.

AU - Van Uden-Kraan, C. F.

AU - Nieuwenhuijzen, G. A. P.

AU - Hardillo, J. A.

AU - de Jong, R. J. Baatenburg

AU - Tiren-Verbeet, N. L.

AU - Sommeijer, D. W.

AU - de Heer, K.

AU - Schaar, C. G.

AU - Sedee, R. J. E.

AU - Bosscha, K.

AU - van den Brekel, M. W. M.

AU - Petersen, F.

AU - Westerman, M.

AU - Honings, J.

AU - Takes, R. P.

AU - Houtenbos, null

AU - van den Broek, W. T.

AU - de Bree, R.

AU - Jansen, P.

AU - Eerenstein, S. E. J.

AU - Leemans, C. R.

AU - Zijlstra, J. M.

AU - Cuijpersa, P.

AU - Van De Poll-Franse, L. V.

AU - Verdonck-de Leeuw, I. M.

N1 - I. M. V.-d. L. has received grants from the Dutch Cancer Society (KWF Kankerbestrijding), Pink Ribbon, the Netherlands Organisation for Health Research and Development (ZonMW), the SAG Foundation–Zilveren Kruis Health Care Assurance Company, Danone Ecofund–Nutricia, Red-kite (distributor of eHealth tools), and Bristol-Myers Squibb, during the conduct of this study. C. R. L. has received personal fees for global advisory board participation from MSD, during the conduct of this study. All other authors report no conflicts of interest.

PY - 2021

Y1 - 2021

N2 - BackgroundOncokompas is a web-based self-management application that supports cancer survivors to monitor their health-related quality of life (HRQOL) and symptoms, and to obtain personalised feedback and tailored options for supportive care. In a large randomised controlled trial among survivors of head and neck cancer, colorectal cancer, and breast cancer and (non-)Hodgkin lymphoma, Oncokompas proved to improve HRQOL, and to reduce several tumour-specific symptoms. Effect sizes were however small, and no effect was observed on the primary outcome patient activation. Therefore, this study aims to explore which subgroups of cancer survivors may especially benefit from Oncokompas.Materials and methodsCancer survivors (n = 625) were randomly assigned to the intervention group (access to Oncokompas, n = 320) or control group (6 months waiting list, n = 305). Outcome measures were HRQOL, tumour-specific symptoms, and patient activation. Potential moderators included socio-demographic (sex, age, marital status, education, employment), clinical (tumour type, stage, time since diagnosis, treatment modality, comorbidities), and personal factors (self-efficacy, personal control, health literacy, Internet use), and patient activation, mental adjustment to cancer, HRQOL, symptoms, and need for supportive care, measured at baseline. Linear mixed models were performed to investigate potential moderators.ResultsThe intervention effect on HRQOL was the largest among cancer survivors with low to moderate self-efficacy, and among those with high personal control and those with high health literacy scores. Cancer survivors with higher baseline symptom scores benefitted more on head and neck (pain in the mouth, social eating, swallowing, coughing, trismus), and colorectal cancer (weight) specific symptoms.DiscussionOncokompas seems most effective in reducing symptoms in head and neck cancer and colorectal cancer survivors who report a higher burden of tumour-specific symptoms. Oncokompas seems most effective in improving HRQOL in cancer survivors with lower self-efficacy, and in cancer survivors with higher personal control, and higher health literacy.

AB - BackgroundOncokompas is a web-based self-management application that supports cancer survivors to monitor their health-related quality of life (HRQOL) and symptoms, and to obtain personalised feedback and tailored options for supportive care. In a large randomised controlled trial among survivors of head and neck cancer, colorectal cancer, and breast cancer and (non-)Hodgkin lymphoma, Oncokompas proved to improve HRQOL, and to reduce several tumour-specific symptoms. Effect sizes were however small, and no effect was observed on the primary outcome patient activation. Therefore, this study aims to explore which subgroups of cancer survivors may especially benefit from Oncokompas.Materials and methodsCancer survivors (n = 625) were randomly assigned to the intervention group (access to Oncokompas, n = 320) or control group (6 months waiting list, n = 305). Outcome measures were HRQOL, tumour-specific symptoms, and patient activation. Potential moderators included socio-demographic (sex, age, marital status, education, employment), clinical (tumour type, stage, time since diagnosis, treatment modality, comorbidities), and personal factors (self-efficacy, personal control, health literacy, Internet use), and patient activation, mental adjustment to cancer, HRQOL, symptoms, and need for supportive care, measured at baseline. Linear mixed models were performed to investigate potential moderators.ResultsThe intervention effect on HRQOL was the largest among cancer survivors with low to moderate self-efficacy, and among those with high personal control and those with high health literacy scores. Cancer survivors with higher baseline symptom scores benefitted more on head and neck (pain in the mouth, social eating, swallowing, coughing, trismus), and colorectal cancer (weight) specific symptoms.DiscussionOncokompas seems most effective in reducing symptoms in head and neck cancer and colorectal cancer survivors who report a higher burden of tumour-specific symptoms. Oncokompas seems most effective in improving HRQOL in cancer survivors with lower self-efficacy, and in cancer survivors with higher personal control, and higher health literacy.

KW - Supportive care

KW - eHealth

KW - self-management

KW - health-related quality of life

KW - cancer survivorship

KW - moderators

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JO - Acta Oncologica

JF - Acta Oncologica

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The eHealth self-management application 'Oncokompas' that supports cancer survivors to improve health-related quality of life and reduce symptoms: Which groups benefit most?

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Keywords

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