{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T19:02:49Z","timestamp":1782846169755,"version":"3.54.5"},"reference-count":27,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Cancer"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Personalized nutritional management during cancer remains challenging in clinical practice. The development of an electronic patient-reported outcome platform (ePROM) provides novel opportunities.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the effectiveness and adherence of nutritional management using ePROM in patients with cancer.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This multicenter prospective longitudinal cohort study included 6124 patients diagnosed with cancer. Exposure was defined as adherence to the ePROM journal, measured by the longest consecutive month of weekly entries. Dietary intake was reported via food selection, voice input, or meal photos. The primary outcomes were adequate energy intake (EI, \u226525 kcal\/kg\/day) and protein intake (PI, \u22651 g\/kg\/day), defined according to European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines. Logistic regression analysis was conducted to identify the factors associated with EI and PI, reporting odds ratios (ORs) and 95% CIs. A restricted cubic spline plot was used to illustrate the association between the adjusted ORs and adherence duration. The semMediation approach was applied to assess the impact of multiple mediators on the outcomes.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The study cohort comprised 3741\/6124 (61.1%) men and 2383 (38.9%) women, with a median age of 60.85 (IQR 53.3-68.3) years. Overall, 1024\/6124 (16.7%) and 2591\/6124 (42.3%) patients achieved adequate EI and PI scores, respectively. At one month, 499\/1024 patients (48.7%) in the adequate EI group and 1287\/2591 (49.7%) in the adequate PI group continued journaling, compared with 1879\/5100 (36.8%) and 1091\/3533 (30.9%) in the corresponding inadequate groups (\n P<\/jats:italic>\n <.001). This trend remained significant in the second, third, and sixth months. Logistic regression analysis demonstrated that longer adherence to ePROM journaling was independently associated with adequate EI (OR 1.05, 95% CI 1.01\u20101.08;\n P<\/jats:italic>\n =.01) and PI (OR 1.22, 95% CI 1.16\u20101.28;\n P<\/jats:italic>\n <.001) after adjusting for confounders. Mediation analysis revealed that most symptoms did not significantly mediate these effects, except for constipation, reflux, and delirium, which showed statistical significance but minimal indirect effects.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Nutritional management via ePROM is a feasible approach, with improved effectiveness as adherence duration increases. The observed benefits resulted primarily from direct effects rather than from symptom improvement.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/75633","type":"journal-article","created":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T09:02:02Z","timestamp":1764666122000},"page":"e75633-e75633","source":"Crossref","is-referenced-by-count":2,"title":["Effectiveness and Adherence of Nutritional Management via Electronic Patient-Reported Outcomes Platform in Patients With Cancer: Multicenter Prospective Longitudinal Cohort Study"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4004-0424","authenticated-orcid":false,"given":"Jiaxin","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1602-2296","authenticated-orcid":false,"given":"Si-Wei","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6244-3956","authenticated-orcid":false,"given":"Le","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4061-4837","authenticated-orcid":false,"given":"Hui-Min","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3869-3856","authenticated-orcid":false,"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0313-6536","authenticated-orcid":false,"given":"Zhi-Gang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4798-419X","authenticated-orcid":false,"given":"Xin-Yi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4161-7247","authenticated-orcid":false,"given":"Zhen-Guang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4888-3981","authenticated-orcid":false,"given":"Ming-Hui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1566-0222","authenticated-orcid":false,"given":"Shu-Qing","family":"Wei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1830-2327","authenticated-orcid":false,"given":"Jun","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1344-9028","authenticated-orcid":false,"given":"Li-Li","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5271-7553","authenticated-orcid":false,"given":"Zhi-Cheng","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1452-6789","authenticated-orcid":false,"given":"Wen-Hui","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4460-8199","authenticated-orcid":false,"given":"Wen-Hao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0109-0792","authenticated-orcid":false,"given":"Qian-Tong","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7285-246X","authenticated-orcid":false,"given":"Ning","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6836-3137","authenticated-orcid":false,"given":"Min","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0561-2906","authenticated-orcid":false,"given":"Meng","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7306-5140","authenticated-orcid":false,"given":"Chen-Xin","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8294-0634","authenticated-orcid":false,"given":"Bao-Hua","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2068-6628","authenticated-orcid":false,"given":"Sheng-Ling","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2845-1500","authenticated-orcid":false,"given":"Rong","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1082-9598","authenticated-orcid":false,"given":"Minghua","family":"Cong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"issue":"5","key":"R1","doi-asserted-by":"publisher","first-page":"107074","DOI":"10.1016\/j.ejso.2023.107074","article-title":"Malnutrition in cancer patients: causes, consequences and treatment options","volume":"50","author":"Arends","journal-title":"Eur J Surg Oncol"},{"issue":"5","key":"R2","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.1016\/j.clnu.2021.02.005","article-title":"ESPEN practical guideline: clinical nutrition in cancer","volume":"40","author":"Muscaritoli","journal-title":"Clin Nutr"},{"issue":"11","key":"R3","doi-asserted-by":"publisher","DOI":"10.3390\/nu12113403","article-title":"Impact of early incorporation of nutrition interventions as a component of cancer therapy in adults: a review","volume":"12","author":"Richards","journal-title":"Nutrients"},{"key":"R4","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2025.1476463","article-title":"Application of oral nutritional supplements to control body weight loss in postoperative patients suffering from solid tumors: a systematic review and meta-analysis","volume":"12","author":"Liu","journal-title":"Front Nutr"},{"issue":"7","key":"R5","doi-asserted-by":"publisher","DOI":"10.3390\/cancers17071128","article-title":"Assessing the impact of nutritional status on the quality of life in head and neck cancer patients-the need for comprehensive digital tools","volume":"17","author":"Anghel","journal-title":"Cancers (Basel)"},{"issue":"6","key":"R6","doi-asserted-by":"publisher","DOI":"10.3390\/nu13061980","article-title":"The spectrum of malnutrition\/cachexia\/sarcopenia in oncology according to different cancer types and settings: a narrative review","volume":"13","author":"Bossi","journal-title":"Nutrients"},{"issue":"4","key":"R7","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1177\/0115426502017004210","article-title":"Nutritional therapy for cancer-induced weight loss","volume":"17","author":"Capra","journal-title":"Nutr Clin Pract"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/47324","article-title":"Effectiveness of home-based telerehabilitation interventions for dysphagia in patients with head and neck cancer: systematic review","volume":"25","author":"Yang","journal-title":"J Med Internet Res"},{"issue":"5","key":"R9","doi-asserted-by":"publisher","first-page":"1141","DOI":"10.1093\/annonc\/mdy114","article-title":"Systematic review and meta-analysis of the evidence for oral nutritional intervention on nutritional and clinical outcomes during chemo(radio)therapy: current evidence and guidance for design of future trials","volume":"29","author":"de van der Schueren","journal-title":"Ann Oncol"},{"issue":"9","key":"R10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0108687","article-title":"Nutritional advice in older patients at risk of malnutrition during treatment for chemotherapy: a two-year randomized controlled trial","volume":"9","author":"Bourdel-Marchasson","journal-title":"PLoS ONE"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1038\/bjc.2017.138","article-title":"Randomised controlled trial of early prophylactic feeding vs standard care in patients with head and neck cancer","volume":"117","author":"Brown","journal-title":"Br J Cancer"},{"issue":"24","key":"R12","doi-asserted-by":"publisher","first-page":"2413","DOI":"10.1001\/jama.2022.9265","article-title":"Effect of electronic symptom monitoring on patient-reported outcomes among patients with metastatic cancer: a randomized clinical trial","volume":"327","author":"Basch","journal-title":"JAMA"},{"issue":"18","key":"R13","doi-asserted-by":"publisher","first-page":"2126","DOI":"10.1200\/JCO.23.01854","article-title":"Electronic patient-reported outcome-based symptom management versus usual care after lung cancer surgery: long-term results of a multicenter, randomized, controlled trial","volume":"42","author":"Dai","journal-title":"J Clin Oncol"},{"issue":"5","key":"R14","doi-asserted-by":"publisher","first-page":"1722","DOI":"10.1111\/cas.15329","article-title":"Feasibility study on collecting patient-reported outcomes from breast cancer patients using the LINE-ePRO system","volume":"113","author":"Hayashida","journal-title":"Cancer Sci"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104588","article-title":"The effectiveness of symptom management interventions based on electronic patient-reported outcomes (ePROs) for symptom burden, quality of life, and overall survival among patients with cancer: a meta-analysis of randomized controlled trials","volume":"147","author":"Li","journal-title":"Int J Nurs Stud"},{"key":"R16","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2021.09.020","article-title":"Electronic patient-reported outcomes monitoring during lung cancer chemotherapy: a nested cohort within the PRO-TECT pragmatic trial (AFT-39)","volume":"162","author":"Mody","journal-title":"Lung Cancer (Auckl)"},{"key":"R17","doi-asserted-by":"crossref","unstructured":"Govindaraj R Agar M Currow D Luckett T . Assessing patient-reported outcomes in routine cancer clinical care using electronic administration and telehealth technologies: realist synthesis of potential mechanisms for improving health outcomes (preprint). J Med Internet Res. Preprint posted online on 2023. [doi: 10.2196\/preprints.48483]","DOI":"10.2196\/preprints.48483"},{"issue":"2","key":"R18","doi-asserted-by":"publisher","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to build a bridge from a population\u2010based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","journal-title":"CA A Cancer J Clinicians"},{"issue":"7","key":"R19","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1200\/JCO.20.02015","article-title":"Phase III randomized controlled trial of eRAPID: eHealth intervention during chemotherapy","volume":"39","author":"Absolom","journal-title":"J Clin Oncol"},{"issue":"6","key":"R20","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1177\/1740774516655101","article-title":"Patient-reported outcomes questionnaire compliance in cancer cooperative group trials (Alliance N0992)","volume":"13","author":"Atherton","journal-title":"Clin Trials"},{"issue":"6","key":"R21","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-024-08547-7","article-title":"Longitudinal assessment of real-world patient adherence: a 12-month electronic patient-reported outcomes follow-up of women with early breast cancer undergoing treatment","volume":"32","author":"Gebert","journal-title":"Support Care Cancer"},{"issue":"4","key":"R22","doi-asserted-by":"publisher","first-page":"3073","DOI":"10.1007\/s00520-021-06661-4","article-title":"Examining guidelines and new evidence in oncology nutrition: a position paper on gaps and opportunities in multimodal approaches to improve patient care","volume":"30","author":"Prado","journal-title":"Support Care Cancer"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.1200\/CCI.22.00187","article-title":"Tenets for implementing electronic patient-reported outcomes for remote symptom monitoring during cancer treatment","volume":"7","author":"Basch","journal-title":"JCO Clin Cancer Inform"},{"issue":"19","key":"R24","doi-asserted-by":"publisher","DOI":"10.3390\/nu15194232","article-title":"The level of adherence to the ESPEN guidelines for energy and protein intake prospectively influences weight loss and nutritional status in patients with cancer","volume":"15","author":"Kipouros","journal-title":"Nutrients"},{"issue":"24","key":"R25","doi-asserted-by":"publisher","DOI":"10.3390\/nu15245030","article-title":"High protein oral nutritional supplements enable the majority of cancer patients to meet protein intake recommendations during systemic anti-cancer treatment: a randomised controlled parallel-group study","volume":"15","author":"Dingemans","journal-title":"Nutrients"},{"issue":"2","key":"R26","doi-asserted-by":"publisher","DOI":"10.3390\/nu13020306","article-title":"The role of nutritional support for cancer patients in palliative care","volume":"13","author":"Cotogni","journal-title":"Nutrients"},{"issue":"4","key":"R27","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.4143\/crt.2024.003","article-title":"Development and feasibility evaluation of smart cancer care 2.0 based on patient-reported outcomes for post-discharge management of patients with cancer","volume":"56","author":"Kwon","journal-title":"Cancer Res Treat"}],"container-title":["JMIR Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/cancer.jmir.org\/2025\/1\/e75633","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:06:45Z","timestamp":1782842805000},"score":1,"resource":{"primary":{"URL":"https:\/\/cancer.jmir.org\/2025\/1\/e75633"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":27,"URL":"https:\/\/doi.org\/10.2196\/75633","relation":{},"ISSN":["2369-1999"],"issn-type":[{"value":"2369-1999","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"article-number":"v11i5e75633"}}