Effect of a Digital Peer Navigation Intervention among Patients after Treatment for Prostate Cancer: A Randomized Controlled Trial

Purpose: Patients with prostate cancer (PC) often lack personalized support and self-management skills and face barriers to care when dealing with treatment-related side effects. We examined the effect of digital peer navigation on patient-reported outcomes after treatment for PC. Patients and Methods: In this phase III trial, conducted in 3 cancer centers in Toronto, Halifax and Vancouver, Canada, patients with localized PC who completed treatment <3 months prior were randomly assigned 1:1 to digital peer navigation or an online resource library (ORL-control). The primary outcome was patient activation (PAM-13; ability to manage one’s health and healthcare) at 3 months. Secondary exploratory outcomes were PAM-13 at 6 months, and quality of life (EQ5D-5L, PORPUS), anxiety (GAD-7), depression (PHQ-9), social support (ESSI), fear of recurrence (FCR-SF), supportive care needs (SCNS-SF34), healthcare use at 3 and 6 months. Results: From May/13/2022 to June/26/2024, 172 eligible patients (mean age 67 ±7.6 years) were randomized. At 3 months, PAM-13 was higher in the intervention compared to ORL-control (adjusted mean difference (AMD)=4.41 [95% CI: 0.96, 7.86]; p=0.012). There were improvements in EQ5D-5L (mean difference (MD)=0.05 [0.006, 0.09]; p=0.021), PHQ-9 (MD=-1.53 [ -3.05, -0.015]; p=0.048), SCNS-SF34 (MD=-7.30 [-14.07, -0.533]; p=0.035) and non-oncology medical specialist use (23.44% vs 45.7%; p=0.007) at 3 months, and SCNS-SF34 (MD=-6.44 [-12.66, -0.22]; p=0.043) at 6 months. Study groups did not differ on PAM-13, EQ5D-5L, or PHQ-9 at 6 months, or the remaining outcomes at 3 or 6 months. Conclusion: Digital peer navigation improved patient activation after PC treatment and may also improve QoL and reduce depression, supportive care needs, and non-oncology medical specialist use. Future work should explore how to implement and sustain the effects of digital peer navigation.