Pilot Feasibility Trial of a Supportive Care Digital Application for Patients with Advanced Nonsmall Cell Lung Cancer

Background: Patients with advanced nonsmall cell lung cancer (NSCLC) experience burdensome symptoms, psychological distress, and poor quality of life (QOL). Objective: We developed and pilot-tested a digital health application ("THRIVE"), consisting of six modules designed to improve patients' symptom management and coping with NSCLC. Design: Randomized pilot feasibility trial. Setting/Subjects: Eligible patients included adults within 12 weeks of an advanced NSCLC diagnosis receiving care at a participating institution in the United States. Measurements: Participants completed baseline and 12-week assessments of QOL (Functional Assessment of Cancer Therapy-Lung), physical symptoms (MD Anderson Symptom Inventory; MDASI), psychological distress (Hospital Anxiety and Depression Scale), and coping (Brief COPE). The primary outcome was study feasibility, defined as ≥65% of approached patients consenting to participate; ≥70% of intervention participants completing ≥4 of 6 app modules; and ≥70% of the sample completing the 12-week assessments. We used the System Usability Scale (SUS) to assess intervention acceptability. Results: Of 232 patients approached, 135 (58.2%) provided consent, and 120 (51.7%) were randomized (Age_mean = 67.90 years, 61.7% female, 90.8% White). Among intervention participants, 70.5% (43/61) completed ≥4 modules, with 77.3% reporting above-average SUS usability ratings for THRIVE. Ninety-four (78.3%) participants completed the 12-week assessments. Conclusions: Although the enrollment rate was lower than anticipated, patients with advanced NSCLC who received THRIVE met the feasibility criterion for app completion and reported high acceptability. These results support conducting a follow-up efficacy trial of THRIVE for improving patients' QOL, physical symptoms, and other psychosocial outcomes.