Background: Optimal care for people with metastatic cancer includes screening for, and addressing, the known psychosocial burden (e.g., fear of cancer progression and prognostic uncertainty) and physical symptoms (e.g., fatigue, pain, sleep difficulties). Psychological interventions have demonstrated efficacy in managing these impacts, with digital interventions often hailed as the solution to access barriers for conventional face-to-face services. While strong evidence now exists to support digital mental health interventions for curatively treated cancer survivors, scant evidence exists on their application to those living with metastatic disease. It is therefore important to explore: (a) whether digital mental health interventions are appropriate for metastatic survivors (i.e., is this modality useful, or is higher-intensity care needed), and (b) if appropriate, for whom (i.e., what is the sociodemographic, clinical and psychosocial profile of digital health users).
Method: Using our current randomised clinical trial (RCT) of Finding My Way-Advanced, an unguided digital mental health intervention for women with metastatic breast cancer, as a case study, this presentation will first summarise key indicators of whether digital mental health is appropriate - does it have adequate (i) reach (percent of referred women that were eligible; percent of eligible women consented); identifying factors on which participants vs decliners differ; (ii) safety (withdrawals/adverse events due to the program); (iii) relevance (is content/program specific and suitable to the population's specific needs). Baseline data will then be summarised to outline the profile of who Finding My Way-Advanced users are.
Results: The RCT has recently closed to recruitment (n=280). Reach: Of the n=784 approached, n=512 were eligible (65%), and n=280 consented (55%). Safety: There were no trial-related adverse events. N=23 withdrawals occurred (8%), due to: being allocated to control (n=3); other commitments (n=4); program-related reasons (navigation n=4; content n=4); withdrew at follow-up (n=5, 1 due to survey-distress); and too unwell (n=3). Further results (relevance and participant-profile) will be discussed.
Conclusions: While preliminary results support this modality as appropriate and safe for those who consent, the modest overall reach indicates that this modality needs to be considered within a suite of resources, as digital health will suit some, but not all, metastatic survivors.