• Paul Little, Katherine Bradbury, Beth Stuart, Jane Barnett, Adele Krusche, Mary Steele, Elena Heber, Steph Easton, Kirsten A Smith, Joanna Slodowska-Barabasz, Liz Payne, Teresa Corbett, Laura Wilde, Guiqing Lily Yao, Sebastien Pollet, Jazzine Smith, Judith Joseph, Megan Lawrence, Dankmar Böhning, Tara Cheetham-Blake, Diana Eccles, Claire Foster, Adam Wa Geraghty, Geraldine Leydon, Andre Matthias Müller, Richard D Neal, Richard Osborne, Shanaya Rathod, Alison Richardson, Chloe Grimmett, Geoffrey Sharman, Roger Bacon, Lesley Turner, Richard Stephens, Kirsty Rogers, James Raftery, Shihua Zhu, Karmpaul Singh, Frances Webley, Gareth Griffiths, Jaqui Nutall, Trudie Chalder, Clare Wilkinson, Eila Watson, and Lucy Yardley.
• Primary Care Research Centre, University of Southampton, Southampton, UK.
• Br J Gen Pract. 2025 Jan 13.

BackgroundMany cancer survivors following primary treatment have prolonged poor quality of life.AimTo determine the effectiveness of a bespoke digital intervention to support cancer survivors.Design And SettingThis was a pragmatic parallel open randomised trial in UK general practices (ISRCTN:96374224).MethodPeople having finished primary treatment (≤10 years previously) for colorectal, breast, or prostate cancers, with European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) score ≤85, were randomised by online software to: 1) detailed 'generic' digital NHS support ('LiveWell'; n = 906); 2) a bespoke complex digital intervention ('Renewed'; n = 903) addressing symptom management, physical activity, diet, weight loss, and distress; or 3) 'Renewed with support' (n = 903): 'Renewed' with additional brief email and telephone support.ResultsMixed linear regression provided estimates of the differences between each intervention group and generic advice. At 6 months all groups improved (primary time point: n for the generic, Renewed groups, and Renewed with support were 806, 749, and 705, respectively), with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both the Renewed groups. By 12 months there were small improvements in EORTC QLQ-C30 for Renewed with support (versus generic advice: 1.42, 95% confidence interval [CI] = 0.33 to 2.51); both Renewed groups improved global health (12 months: Renewed: 3.06, 95% CI = 1.39 to 4.74; Renewed with support: 2.78, 95% CI = 1.08 to 4.48), dyspnoea, constipation and enablement, and lower primary care NHS costs (in comparison with generic advice [£265]: Renewed was -£141 [95% CI = -£153 to-£128] and Renewed with Support was -£77 [95% CI = -£90 to -£65]); and for Renewed with support improvement in several other symptom subscales. No harms were identified.ConclusionCancer survivors' quality of life improved with detailed generic online support. Robustly developed bespoke digital support provides limited additional short-term benefit, but additional longer-term improvement in global health, enablement, and symptom management, with substantially lower NHS costs.© The Authors.

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