The efficacy of WeChat-based multidisciplinary full-course nutritional management program on the nutritional status of ovarian cancer patients undergoing chemotherapy: a Randomized Controlled Trial (Preprint)

Abstract

As the most malignant type of cancer in the female reproductive system, ovarian cancer (OC) has become the second leading cause of death among Chinese women. Chemotherapy is the main treatment for OC patients, and its numerous adverse effects can easily lead to malnutrition. It is difficult to centrally manage OC patients in the intervals between chemotherapy. The utility of WeChat, an effective and more cost-efficient mobile tool, in chronic disease management has been highlighted.

This study aimed to implement a continuous follow-up strategy and health monitoring based on a WeChat platform for OC patients undergoing chemotherapy during the chemotherapy interval to ensure that each phase of chemotherapy was delivered on schedule and to improve the survival rate of cancer patients.

Participants were recruited and randomly assigned to either the WeChat-based nutrition intervention group or the usual care group. A self-administered general information questionnaire was used at enrolment to obtain basic information about the patients. The PG-SGA scale was used to investigate the nutritional status of the patients at three time points (T0=before the first admission to the hospital for chemotherapy, T1=2 weeks after the first chemotherapy, and T6=2 weeks after the sixth chemotherapy). The blood indices of patients were investigated through the in-hospital healthcare system at the three times mentioned above. Patients in the intervention group were introduced to the main functional panels of the nutrition applet, invited to join the nutrition management group chat, and allowed to consult on nutritional issues in private chats with members of the nutrition management team via WeChat. Linear mixed models were used to analyze changes in each nutritional indicator in the two groups with their baseline measurements as covariates, with group, time and group-time interactions considered as fixed effects and patients considered as random effects.

A total of 96 OC patients undergoing chemotherapy were recruited into the study. Distribution was based on a 1:1 ratio, with 48 patients in each of the nutrition intervention group and the usual care group. The attrition rate after the first chemotherapy session was 18.75%. The mixed linear model revealed that the group-based effect and the group-time interaction effect on PG-SGA scores was significant (F = 4.763, P = 0.031; F = 6.368, P = 0.013), whereas the time-based effect on PG-SGA scores was not (F = 0.377, P=0.540). The findings indicated that the group-based effect, the time-based effect and the group-time interaction effect on nutrition-inflammation composite indices was significant (F = 7.653, P = 0.006, F = 13.309, P＜0.001; F = 92.304, P＜0.001, F = 110.675, P＜0.001; F = 10.379, P = 0.002, F = 5.289, P = 0.023).

This study provided evidence that WeChat-based multidisciplinary, full-course nutritional management program improved the nutritional status of OC patients undergoing chemotherapy. WeChat platform, an innovative nutritional management model, can significantly improve the nutritional status of OC patients during chemotherapy.