Impact of nurse navigation and mobile app on brain tumor patients receiving oral anticancer therapy

TL;DR

A nurse-led program with a mobile app improved treatment adherence and outcomes for brain tumor patients taking oral anticancer drugs.

Contribution

A nurse navigator and digital platform significantly improved dose intensity and patient experience in brain tumor patients on oral anticancer therapy.

Findings

The intervention group had a significantly higher Relative Dose Intensity (RDI) compared to the control group.

Fewer emergency room visits and hospitalizations were observed in the intervention group.

Remote monitoring helped adjust corticosteroids early, preventing hospitalizations.

Abstract

Oral anticancer agents (OAAs) are commonly prescribed for patients with primary brain tumors, but adherence can be challenging due to cognitive impairment and discontinuous treatment schedules. This subgroup analysis of the randomized phase 3 CAPRI trial evaluated the impact of a nurse navigator-led intervention combined with a digital platform (web portal and mobile app) versus standard care in patients with primary brain tumors treated with OAAs. The primary endpoint was Relative Dose Intensity (RDI), with secondary endpoints including adherence, toxicity, healthcare utilization, and patient-reported experience. Fifty-one patients were included between October 2016 and May 2019, 63% of whom had glioblastoma. Twenty-six patients received the intervention. RDI was significantly higher in the intervention group compared to the control group (105% ± 12 vs. 97.6% ± 13, p = 0.04). The intervention also resulted in fewer emergency room visits, reduced hospitalizations, greater use of supportive care services, and improved patient-reported experience (all p < 0.05). Remote monitoring allowed early corticosteroid adjustments in cases suggestive of intracranial hypertension, helping to prevent hospitalizations. No significant differences were observed in treatment-related toxicity. These findings suggest that a nurse navigator-led digital intervention can improve care continuity and outcomes in this population and merit further investigation.

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