{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:47:23Z","timestamp":1782506843820,"version":"3.54.5"},"reference-count":26,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"2","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO Clin Cancer Inform"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>PURPOSE<\/jats:title>\n                    <jats:p>We evaluated whether offering access to a multicomponent mHealth app improves quality of life (QoL) and psychosocial outcomes among breast cancer survivors under pragmatic, nonprescriptive conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>In this single-center, randomized, controlled trial at Hospital Cl\u00ednic de Barcelona, women age \u226518 years, disease-free after breast cancer treatment, were recruited (December 2020-December 2021) and randomly assigned 1:1 to usual follow-up plus app access or usual follow-up alone. The app provided CTCAE v4.03-aligned symptom tracking with self-care guidance, educational content, an events calendar, and gamified smartphone-based step counting; no protocolized clinician monitoring or feedback was provided. Outcomes were assessed at baseline and 3, 6, 9, and 12 months using European Organisation for Research and Treatment of Cancer-Quality of Life Questionnaire (QLQ)-C30\/BR23, Hospital Anxiety and Depression Scale (HADS), and Three-Item Loneliness Scale (TILS). The primary end point was the difference in QLQ-C30 Global Health Status\/QoL at 3 months. Analyses followed intention-to-treat using mixed models for repeated measures adjusted for baseline values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Of 124 women assessed, 121 were randomized (intervention n = 60; control n = 61). Patient-reported outcome measures were available for 106 of 121 (87.6%) at 3 months and 95 of 121 (78.5%) at 12 months. At 3 months, there was no significant difference in Global Health Status\/QoL (adjusted mean difference [Intervention-Control], -2.24 [95% CI, \u22129.29 to 4.81];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .53); estimates at later time points were similarly imprecise. No significant between-group difference were observed for QLQ-BR23 domains, HADS anxiety\/depression, or TILS. Exploratory subgroup analyses suggested possible heterogeneity in TILS by hormonal-treatment category; this was descriptive and hypothesis-generating only. App engagement was the highest in months 0-3 (48\/60 [80.0%] with any use) and declined thereafter; 12 of 60 (20.0%) never used the app.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In a pragmatic, nonprescriptive survivorship trial, offering access to a multicomponent mHealth app without closed-loop clinical integration did not show a statistically significant between-group differences in QoL or psychosocial outcomes; confidence intervals were compatible with meaningful harm and did not exclude small benefit depending on the threshold used to define clinical relevance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/cci-26-00025","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:00:11Z","timestamp":1782504011000},"update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Effect of a Multidimensional Digital Health Intervention on Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial"],"prefix":"10.1200","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct05401643","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8882-3703","authenticated-orcid":true,"given":"Maria-Angeles","family":"Fuentes-Exp\u00f3sito","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n iSYS, Internet, Salud y Sociedad, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8400-5770","authenticated-orcid":true,"given":"Santiago","family":"Frid","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7772-1437","authenticated-orcid":true,"given":"Montserrat","family":"Mu\u00f1oz-Mateu","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1014-051X","authenticated-orcid":true,"given":"Immaculada","family":"Grau-Corral","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n iSYS, Internet, Salud y Sociedad, Barcelona, Spain"},{"name":"Hospital Cl\u00ednic de Barcelona, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_8_2_2","volume-title":"Las cifras del c\u00e1ncer de mama en Espa\u00f1a 2022","unstructured":"Las cifras del c\u00e1ncer de mama en Espa\u00f1a 2022. https:\/\/seom.org\/images\/LAS_CIFRAS_DEL_CANCER_EN_ESPANA_2022.pdf"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1011024"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.6414"},{"key":"e_1_3_8_5_2","article-title":"Mapping the evidence on the impact of mHealth interventions on patient-reported outcomes in patients with breast cancer: A systematic review.","author":"Frid S","unstructured":"Frid S, Amat-Fern\u00e1ndez C, Fuentes-Exp\u00f3sito MA, et al: Mapping the evidence on the impact of mHealth interventions on patient-reported outcomes in patients with breast cancer: A systematic review. 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