Human Coaching Via Mobile App May Reduce Postgastrectomy Symptoms

The implementation of early interactive human coaching via a mobile app was associated with fewer symptoms in health-related quality of life (HRQOL) scales compared with conventional counseling in patients with gastric cancer postgastrectomy, according to findings from a prospective randomized controlled trial (NCT04394585) published inthe Journal of Medical Internet Research (JMIR).¹

Of patients assigned to the mobile coaching group (n = 76), 66% were deemed active users for 8 weeks or more. No significant differences in characteristics emerged between inactive and active users except for the complication rate, which was 12% vs 0%, respectively (P = .04). Additionally, the most performed activities after 3 months in both groups included meal input (285.6 vs 26.8), messaging (79.5 vs 12.8), and body weight input (45.5 vs 5.6). A median number of total activities was 487.5 (IQR, 234.5-629.3) vs 16.0 (IQR, 2.8-82.5) in the active and inactive groups, respectively, after 3 months.

Additionally, in both groups, activity generally decreased with time. In the active user group, a median of at least 40 logs per week was recorded, and at least 30 logs were maintained until week 12. In the inactive group, fewer than 20 logs were recorded in the first week, and no records were logged after week 7.

“The applicability of the mobile app in patients postgastrectomy with gastric cancer was an important finding of this study. In previous studies, app activity was evaluated using various parameters, including the mean number of log-ins, median number of days visiting the app, and average time spent on the app, which made it difficult to summarize the results,” Bang Wool Eom, researcher at the National Cancer Center in Goyang-si, Republic of Korea, wrote in the publication with study coinvestigators. “Our study demonstrated similar app activity, with 66% (50/76) of patients whose mean age was 60.8 (SD 9.5) years using the mobile app coaching program for ≥8/12 weeks. These app activity data provide a solid foundation for planning further studies, and adherence could increase over time as people become more familiar with mobile apps.”

Regarding eating restriction scores in the conventional counseling and mobile coaching groups, no significant difference was observed, with mean values of 28.2 (SD, 19.3) and 27.9 (SD, 20.4), respectively (P = .89). Additionally, the mobile coaching cohort experienced significantly reduced dyspnea throughout the study period (P = .01), decreased eating restriction at 6 months (P = .045), and lower perceived body image by 3 months postoperatively (P = .04) compared with the conventional counseling group. Furthermore, no other significant differences in the remaining functional and symptom scales emerged between the groups.

Among 196 assessed for enrollment eligibility between May 2020 and August 2022, 180 were enrolled and were randomly assigned 1:1 to receive the mobile coaching approach (n = 89) or conventional counseling (n = 91). However, 160 patients remained after 20 were excluded due to ongoing adjuvant chemotherapy (n = 17) or withdrawal (n = 3), with 84 and 76 patients in the conventional and mobile counseling groups, respectively.

Those enrolled in conventional counseling and mobile coaching groups had a median age of 58.7 years (SD, 9.7) vs 60.8 years (SD, 9.5). Most patients in either group were male (56% vs 64.5%), and 36.9% vs 44.7% had comorbidities. The most common comorbidities included hyperlipidemia (15.5% vs 17.1%), diabetes mellitus (9.5% vs 22.4%), and hypertension (9.5% vs 3.9%).

Most patients in either group had pathological stage IA disease (79.8% vs 71.1%), distal operations (90.5% vs 90.8%), and no complications present (96.4% vs 96.1%). The median duration of hospital stay was 7 days (IQR, 7-7) and 7 days (IQR, 6-7). Tumors were most frequently located in the middle third of the gastrointestinal tract (54.8% vs 52.6%).

The primary end point of the trial was the eating restriction scale of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire gastric cancer module (EORTC QLQ STO22), 1 month following gastrectomy. Secondary end points included changes in QOL per EORTC QLQ Core 30 and EORTC QLQ-STO22, which evaluate the general QOL of patients with cancer and the QOL of gastric-specific patients, respectively. Other secondary end points encompassed food intake, body weight, and serum levels for up to 3 months postoperatively.²

References

1. Eom BW, Han M, Yoon HM, et al. Improvement in quality of life after early interactive human coaching via a mobile app in postgastrectomy patients with gastric cancer: prospective randomized controlled trial. J Med Internet Res. 2025;13;e75445. doi:10.2196/75445
2. Effect of smart phone app-based human coaching program in gastrectomized patients. ClinicalTrials.gov. Updated April 13, 2025. Accessed December 24, 2025. https://tinyurl.com/54m46zea