Customized Text Messaging to Assist Cancer Patients with Diet, Nutrition and Activity: a Pilot Study

Abstract

There is ample evidence supporting the significance of diet and nutrition in cancer prevention and management. Yet providing comprehensive nutritional support presents with challenges. In this study, we tested the feasibility of providing patients with a cost-effective, hands-on text-messaging platform, in order to implement nutritional support and increase patient engagement throughout the course of radiation therapy cancer treatment. Patients to receive curative radiation treatment for head and neck (H&N), breast or prostate cancers were screened for eligibility. Those consented were enrolled onto a HIPPA compliant texting platform, and set to receive 3-5 text messages a day. Messages sent were specific to diagnosis and treatment time point. Patient responses triggered automated texts from the platform, and notifications were sent to providers when there was a more personalized patient need. Weekly quality of life and post-treatment feedback surveys were collected. Patient engagement was measured by number of text responses and end of treatment feedback score. Of the 25 patients enrolled, 22 completed the program and 3 were screen fails. Breakdown by diagnosis included 7 H&N, 9 breast and 6 prostate. Prostate cancer patients showed the highest engagement, at a mean 59.3 (IQR 60-8.25) total responses throughout treatment. Of the breast and prostate patients, only 1 was referred to a nutritional specialist during the study. Overall feedback scores averaged at 81.3% (IQR 91.7-71.9). On a categorical level, “ease of use” scored the highest rating at 94% (IQR 100-87.5). Impact of the recommendations on changing eating habits scored 59.5% (IQR 75-37.5). Ninety-five percent of patients said they would recommend the program to others. There were no significant weight changes for the breast or prostate patients. Weight expectedly dropped for H&N patients, but returned to baseline by month 3 post treatment and study intervention. There are many challenges to providing comprehensive nutritional support for cancer patients. While most H&N patients receive dietary guidance per standard of care, the same is not always true for breast and prostate patients. A simple texting program can provide the nutritional education and motivation needed for these patients, with minimal costs or time required. Feedback from patients supported a comfortable, appropriate, and easy to use platform. Use increased patient engagement with their clinical care. A future program can tie in activity monitoring and be more tailored to specific needs of each patient, controlling for treatment course or concurrent therapies. Such could offer all types of oncology patients the nutritional and dietary support needed to tolerate treatment and maintain long-term, healthy habits throughout recovery.