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Palliative CareSUPPORT+NCT07475312

SUPPORT+ Digital Self-Management and Clinical Support for Advanced Cancer

A study testing SUPPORT+ Digital Symptom Monitoring and Clinical Support in people with Palliative Care and Advanced Cancer, run by The University of Hong Kong at 1 site in Hong Kong.

Active, not recruiting

Under way, not looking for participants. Everyone needed has enrolled. The study is still running.

Official record
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Trial summary

The goal of this clinical trial is to learn whether SUPPORT+, a digital symptom monitoring and self-management mobile application, can improve health-related quality of life and clinical outcomes in adults with advanced cancer receiving palliative care. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Palliative Care, Advanced Cancer
What is being tested?
SUPPORT+ Digital Symptom Monitoring and Clinical Support
Could I receive a placebo?
No, everyone receives an active treatment
How many people
633 participants
Where
1 siteHong Kong
Study dates
16 Jan 2023to 31 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults aged 18 years or older
  • Diagnosis of advanced malignancy
  • Decision not to pursue further systemic anticancer treatment
  • Receiving follow-up care at a participating palliative care clinic
  • Community-dwelling
  • Ownership of a smartphone
Show all 10Show fewer
  • Adequate cognitive capacity to provide informed consent
  • Willingness to receive notifications from the SUPPORT+ mobile application
  • Presence of at least one symptom related to advanced cancer
  • Ability for the patient or a designated primary caregiver to use the mobile application

Who cannot join

  • Receiving systemic anticancer therapy with radical or palliative intent
  • Estimated life expectancy of less than 3 months
  • Eastern Cooperative Oncology Group (ECOG) performance status greater than 3

Trial locations and contacts

1 site in 1 country.

Hong Kong1 site
  • 1. Department of Clinical Oncology, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong SAR

    Hong Kong

Other trials in Hong Kong

About this study

Official title: SUPPORT+ Digital Self-Management and Clinical Support for Patients With Advanced Cancer in the Community: A Randomized Controlled Trial

The goal of this clinical trial is to learn whether SUPPORT+, a digital symptom monitoring and self-management mobile application, can improve health-related quality of life and clinical outcomes in adults with advanced cancer receiving palliative care.

The main questions this study aims to answer are:

Read more
  • Does use of SUPPORT+ help maintain or improve health-related quality of life compared with usual palliative care?
  • Does SUPPORT+ reduce functional decline and acute health care use, such as hospitalisations, compared with usual care?

Researchers will compare patients using the SUPPORT+ mobile application with patients receiving usual palliative care to see if digital symptom monitoring combined with automated self-management guidance and nurse follow-up improves patient-reported and clinical outcomes.

Participants assigned to the SUPPORT+ arm will:

  • Use the SUPPORT+ mobile application for weekly symptom reporting using the Integrated Palliative Care Outcome Scale (IPOS)
  • Receive automated self-management advice based on reported symptoms
  • Receive follow-up contact from a nurse when severe or concerning symptoms are identified
  • Continue to receive usual palliative care throughout the study period

Participants assigned to the usual care arm will:

  • Receive usual palliative care provided by their clinical team
  • Complete study assessments at scheduled time points
  • Not receive digital symptom monitoring, automated self-management advice, or nurse follow-up through the SUPPORT+ application
Read the detailed description

Patients with advanced cancer often experience substantial physical and psychological symptom burden that negatively affects health-related quality of life and may lead to avoidable emergency department visits and hospitalisations. Digital symptom monitoring tools may support earlier identification of symptom deterioration and timely intervention, but evidence in palliative care populations remains limited.

This multicentre, randomised controlled trial evaluated whether adding SUPPORT+, a mobile application for symptom monitoring with automated self-management guidance and nurse follow-up, to usual palliative care could improve patient-reported outcomes and healthcare utilisation among adults with advanced cancer.

Community-dwelling adults aged 18 years or older with advanced malignancy who had decided not to pursue further systemic anticancer treatment and were receiving follow-up at palliative care clinics in six public hospitals in Hong Kong were recruited. Eligible participants were required to own a smartphone, have adequate cognitive capacity to provide informed consent, be willing to receive application notifications, and report at least one symptom related to advanced cancer. Patients with an estimated life expectancy of less than three months or an Eastern Cooperative Oncology Group (ECOG) performance status greater than 3 were excluded. Caregivers were permitted to act as proxy users when participants were unable to use the application independently.

Participants were randomly assigned in a 1:1 ratio to either the intervention group (SUPPORT+ plus usual care) or the usual care group. Randomisation was stratified by age, chronic opioid use, and app user (patient or caregiver proxy). Clinicians providing routine palliative care were not informed of group allocation.

All participants received standard palliative care according to usual clinical practice. Participants in the intervention group additionally received full access to the SUPPORT+ mobile application for 18 weeks. Weekly notifications prompted symptom reporting using the Integrated Palliative Care Outcome Scale (IPOS). Following each submission, participants received automated symptom-specific self-management advice. Reports containing any severe symptom triggered real-time alerts to palliative care nurses, who contacted participants during office hours to provide clinical guidance, including medication advice, self-management strategies, expedited clinic review, or recommendations for urgent care when appropriate. Participants could also initiate nurse contact through the application during office hours.

Assessments were conducted at baseline, week 9, and week 18. The primary outcome was change in health-related quality of life measured using the EQ-5D-5L utility score. Secondary outcomes included self-rated health (EQ-VAS), self-efficacy for managing chronic disease, ECOG performance status, emergency department visits, hospitalisations, length of hospital stay, and completion of advance directives. Healthcare utilisation data were retrieved from electronic medical records.

Being tested
SUPPORT+ Digital Symptom Monitoring and Clinical Support
Keywords
health related quality of life, hospitalisation, digital symptom monitoring, Palliative Care Outcome Scale (IPOS)

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SUPPORT+ Digital Symptom Monitoring and Clinical SupportBehavioural

    SUPPORT+ is a mobile application that prompts participants to complete weekly symptom reporting using the Integrated Palliative Care Outcome Scale (IPOS). After each submission, the application provides automated, symptom-specific self-management advice. Reports indicating severe symptoms trigger real-time alerts to palliative care nurses, who contact participants during office hours to provide clinical guidance, including medication advice, self-management strategies, expedited clinic review, or recommendations for urgent medical care when appropriate. Participants may also initiate nurse contact through the application during office hours.

Study groups in NCT07475312
Study groupRoleWhat they receive
SUPPORT+ Plus Usual Palliative CareExperimentalParticipants in this arm receive usual palliative care supplemented by SUPPORT+, a mobile application providing weekly digital symptom monitoring, automated self-management guidance, and nurse follow-up for severe symptoms, for a duration of 18 weeks. After each submission, participants received symptom-specific self-management advice. Any report containing a severe symptom was transmitted in real time to palliative care nurses, who contacted patients within one working day during office hours to provide clinical support, including medication adjustments, self-management strategies, expedited appointments, or advice to attend the emergency department or admit to hospital. Participants could also contact nurses during office hours via the "Nurse Consult" feature; outside these hours, they were advised to seek urgent medical care.
Receives: Behavioral: SUPPORT+ Digital Symptom Monitoring and Clinical Support
Usual Palliative CareNo interventionParticipants in this arm receive usual palliative care provided by their clinical team according to standard practice, without access to digital symptom monitoring, automated self-management guidance, or nurse follow-up through the SUPPORT+ application. They could access only the publicly available educational materials within the SUPPORT+ application.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Health-Related Quality of Life (EQ-5D-5L index)

    Change in health-related quality of life measured using the EQ-5D-5L index (utility) score. The EQ-5D-5L assesses five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, each rated on five levels from 1 (no problems) to 5 (extreme problems). Utility scores are derived using the Hong Kong value set and range from -0.865 (worst health state) to 1 (perfect health).

    Measured: Baseline to 18 weeks

  2. Change in Self-rated health measured by EQ-VAS

    Change in self-rated health measured using the EQ-5D visual analogue scale (EQ-VAS), on which participants rate their overall health on a vertical scale from 0 (worst imaginable health) to 100 (best imaginable health).

    Measured: Baseline to 18 weeks

Secondary outcomes (4)
  1. Change in Self-Efficacy for Managing Chronic Disease

    Change in self-efficacy measured using the 6-item Self-Efficacy for Managing Chronic Disease Scale (SEMCD-6S). The SEMCD-6S assesses an individual's confidence in managing symptoms and the impact of a chronic condition on daily life, including fatigue, pain, emotional distress, symptom control, and self-management activities. Each item is rated on a numeric scale from 1 (not at all confident) to 10 (totally confident). The overall score is calculated as the mean of the six items, with higher scores indicating greater self-efficacy.

    Measured: Baseline to 18 weeks

  2. Change in Eastern Cooperative Oncology Group (ECOG) Performance Status

    Change in functional status measured using the Eastern Cooperative Oncology Group (ECOG) Performance Status scale. The ECOG scale is a clinician-rated measure of a patient's level of functioning and ability to perform daily activities, ranging from 0 to 4, with lower scores indicating better functional status. Scores are defined as follows: 0 = fully active with no restrictions; 1 = restricted in physically strenuous activity but ambulatory and able to perform light work; 2 = ambulatory and capable of all self-care but unable to work; 3 = capable of only limited self-care and confined to bed or chair more than 50% of waking hours; 4 = completely disabled and unable to perform any self-care.

    Measured: Baseline to 18 weeks

  3. Emergency Department Visits

    Number of emergency department visits recorded in electronic medical records.

    Measured: Baseline to 18 weeks

  4. Hospitalisations

    Number of hospital admissions and total length of hospital stay recorded in electronic medical records.

    Measured: Baseline to 18 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2026
  2. Study start16 Jan 2023
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
This study uses a parallel-group randomized controlled trial design. Eligible participants are randomly assigned in a 1:1 ratio to either the intervention arm (SUPPORT+ plus usual palliative care) or the control arm (usual palliative care alone). Participants remain in their assigned group for the duration of the 18-week study period. Outcomes are assessed at predefined time points and compared between groups to evaluate the effects of adding digital symptom monitoring with automated self-management guidance and nurse follow-up to usual palliative care.
Masking
None (open label)
Enrolment
633 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07475312
Sponsor's protocol ID
CIRB-2023-011-3
Acronym
SUPPORT+
Status last verified
Mar 2026
First submitted
11 Mar 2026
Last updated
2 Apr 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared because data sharing was not approved by the Institutional Review Board and is restricted to protect participant privacy and confidentiality.

Publications

  • Chan WL, Soong IS, Lim MY, Tin WW, Siu SW, Ng J, Leung C, Leung A, Tai YL, Lam CM, Hou LY, Lo R, Lee VH, Yuen KK, Kwong D, Hui R. Digital Self-Management of Symptoms and Quality of Life for Patients With Advanced Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2026 Jun 1;9(6):e2615509. doi: 10.1001/jamanetworkopen.2026.15509.

    PubMed 42224222

Questions about this trial

What is this clinical trial studying?

A study testing SUPPORT+ Digital Symptom Monitoring and Clinical Support in people with Palliative Care and Advanced Cancer, run by The University of Hong Kong at 1 site in Hong Kong.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: under way, not looking for participants, as of the sponsor's last update on 2 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Hong Kong. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Health-Related Quality of Life (EQ-5D-5L index) (time frame: Baseline to 18 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07475312, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Apr 2026.

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