• Paul Little, Katherine Bradbury, Beth Stuart, Jane Barnett, Adele Krusche, Mary Steele, Elena Heber, Steph Easton, Kirsten Ailsa Smith, Joanna Slodkowska-Barabasz, Liz Payne, Teresa Corbett, Guiqing Yao, Sebastien Pollet, Jazzine Smith, Judith Joseph, Megan Lawrence, Dankmar Bohning, Tara Cheetham-Blake, Diana Eccles, Claire Foster, GeraghtyAdam W AAWAUniversity of Southampton Faculty of Medicine Health and Life Sciences, Southampton, United Kingdom., Geraldine Leydon, Andre Muller, Richard Neal, Richard Osborne, Shanaya Rathod, Alison Richardson, Chloe Grimmett, Geoff Sharman, Roger Bacon, Lesley Turner, Richard Stephens, Tamsin Burford, Laura Wilde, Karen Middleton, Megan Liddiard, Kirsty Rogers, James Raftery, Shihua Zhu, Fran Webley, Gareth Griffiths, Jaqui Nutall, Trudie Chalder, Clare E Wilkinson, Eila Watson, and Lucy Yardley.
• University of Southampton, Department of Psychology, Southampton, United Kingdom p.little@soton.ac.uk.
• Br J Gen Pract. 2023 Dec 20.

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.DesignPragmatic parallel open randomised trial.SettingUK general practices.MethodsPeople having finished primary treatment (<= 10 years previously) for colo-rectal, breast or prostate cancers, with European-Organization-for-Research-and-Treatment-of-Cancer 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, 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 (primary time point: n's respectively 806;749;705) all groups improved, with no significant between-group differences for EORTC QLQ-C30, but global health improved more in both intervention groups. By 12 months there were: small improvements in EORTC QLQ-C30 for Renewed-with-support (versus generic advice: 1.42, 95% CIs 0.33-2.51); both groups improved global health (12 months: renewed: 3.06, 1.39-4.74; renewed-with-support: 2.78, 1.08-4.48), dyspnoea, constipation, and enablement, and lower NHS costs (generic advice £265: in comparison respectively £141 (153-128) and £77 (90-65) lower); 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.Copyright © 2023, The Authors.

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