Digital Supportive Care Awareness and Navigation (D-SCAN): Qualitative and Quantitative Results of a Pilot Randomized Trial in Patients with Advanced Cancer (GP745)

Objectives Demonstrate knowledge of unmet supportive care needs in patients with cancer. Establish the Digital Supportive Care Awareness and Navigation (D-SCAN) application as a feasible method of enhancing patient knowledge of available services in the Duke Cancer Patient Support Program. Importance. In crowded clinics with rising care complexity, clinicians struggle to assess and manage cancer supportive care needs. Duke Cancer Patient Support Program (DCPSP) services aim to bridge this gap, but many patients are unaware of these services. Objective(s). We hypothesized that a DCPSP mobile application (app) is a feasible approach to this problem. Method(s). We developed an app to enhance DCPSP awareness and facilitate weekly symptom reporting (via the Edmonton Symptom Assessment Scale, ESAS). Based upon symptoms, the app presents information and recommendations for specific DCPSP services. We enrolled 50 patients with advanced cancer (2 arms; 25 app intervention, 25 control) and 10 caregivers to a 12-week pilot. The primary outcome was feasibility. Secondary measures assessed knowledge/use of DCPSP services, app usability, satisfaction with the app, quality of life (QoL), and patient activation. We also interviewed participants about the experience. Results. Forty-five patients completed the study, exceeding our feasibility threshold. Most were age 50-64; the most common cancers were breast (42%) and lung (18%). Knowledge/use of DCPSP services increased in both arms, with a larger trend in the intervention arm (2.5 vs 4.0 score increase). App patients (n¼25) completed a median of 7 ESAS surveys for an overall response rate of 57%. The most commonly-reported moderate/severe symptoms were fatigue (40%), drowsiness (22%), and pain (20%), with 54% of surveys from 23 of 25 patients reporting at least one moderate/severe symptom. Satisfaction scores were high, and qualitative feedback was positive. We found no differences in QoL or patient activation. Caregivers had significant improvement in awareness/use of services (median increase 4.5, p¼0.01). Conclusion(s). The D-SCAN app is a feasible approach to augmenting supportive care awareness and navigation, with high satisfaction and usability scores. Impact. The trend towards enhanced awareness/ engagement of DCPSP services in app utilizers warrants further testing.