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Trial with new monitoring system for cancer patients

The Letsgo project combines long-distance medical monitoring with personal coaching. The objective is that patients make lifestyle changes and live longer and avoid unnecessary doctor’s visits.

The Letsgo project is set up to enable patients to take more responsibility for their own health situation. (Illustrative picture: Anette Strømsbo Gjørv, Sørlandet hospital)

All women with a history of gynaecological cancer are monitored by a medical specialist during a period after their last treatment. However, women tend to wait to report any new symptoms if they know they have a doctor’s appointment in a few months’ time. In the meanwhile, they may have become seriously ill.

Sveinung Berntsen, professor and Head of Department of Sports Science and Physical Education at UiA.

Sveinung Berntsen, professor og leder for Institutt for idrettsvitenskap og kroppsøving på UiA.

“Instead of increasing the number of doctor’s visits, we would rather refer patients to a specialized nurse who acts as a lifestyle coach.  At the same time, we ask patients to report any symptoms themselves through a special app. The objective is that patients change their lifestyle and live longer, while the number of doctor’s visits is reduced simultaneously”, says professor Sveinung Berntsen.

Berntsen is Head of the Department of Sports Science and Physical Education at the University of Agder (UiA), and one of the instigators of project Letsgo, which is a collaboration between the university and Sørlandet Hospital and supported by the Norwegian Cancer Society and the South-Eastern Norway Regional Health Authority.

Symptoms and exercising

All patients participating in the research project receive access to an app. With regular intervals, this app sends out a questionnaire with regards to ten different signs of relapse In the event of a high score on any symptoms, they will be told to contact the hospital. In this way, it is possible to discover and monitor any relapse considerably earlier than previously.

The app will also help the patients to change their lifestyle. Users can set an activity goal, receive activity reminders, download adapted exercise programmes with illustrations and videos, and receive tailor-made information. Project participants are given a fitness tracker, which together with the app will help them obtain a more active lifestyle. Specially trained nurses will coach the process, explaining the individual patient how to integrate more physical activities into everyday life.   

FAKTA/Letsgo

  • LETSGO stands for Lifestyle and Empowerment Techniques in Survivorship of Gynaecologic Oncology
  • A multi-centre interventional study on the monitoring of patients in remission from gynaecological cancer in which 10 Norwegian hospitals participate.
  • The project is managed by gynaecologist and senior consultant Ingvild Vistad, Sørlandet hospital.
  • Five hospitals will continue the usual monitoring procedure and function as a control group. Another five hospitals will change their monitoring procedure by replacing half of the doctor check-ups by assistance from a nurse.
  • The nurse focusses on symptoms indicating a possible relapse, on motivating lifestyle changes and the need for rehabilitation together with the patient. Patients will also be introduced to the LETSGO app as an additional support.  
  • The University of Agder has created an educational programme that nurses must complete to qualify as lifestyle coaches

The following hospitals participate in the project:

  • Intervention hospitals: Sørlandet Hospital Kristiansand, The Hospital of Vestfold, Stavanger University Hospital, the University hospital of Nord-Norge and Akershus University Hospital.
  • Control group hospitals: Sørlandet Hospital Arendal, The Hospital of Østfold, Oslo, University Hospital Radiumhospitalet, Nordland’s Hospital and St. Olav’s Hospital.
A screen shot from the Letsgo- app shows some of the user options.

Et skjermbilde fra Letsgo-appen viser noen av mulighetene brukerne har.

“It is important to be regularly physically active and keep a healthy lifestyle, also for this group. Some patients may have reservations towards physical exercise, and we hope the app will be able to reduce these. A lifestyle with little physical activity can increase the chance of developing lifestyle diseases”, says Berntsen.

That the patients themselves take more responsibility for their own health situation is one of the most important elements of Letsgo.

May lead to increased longevity and save money

Berntsen has done research on lifestyle, physical exercise and cancer for more than ten years. He explains that the monitoring procedure for cancer patients in remission is only to a very limited degree based on knowledge.  We do not know enough either on how to motivate individual patients to take more responsibility for their own health situation, nor on how to get some patients to change their lifestyles without having a personal trainer moving in with them.

“If this turns out to be a good system to prevent relapse, obtain a healthier lifestyle, and save money, then it is only natural to think that it may become the new standard system for the monitoring period. The idea is that the future’s health care system can adapt and offer this system to new patients”, says Berntsen

Letsgo is at present on trial at five hospitals in Norway, from Kristiansand in the south to Tromsø in the north, with another five hospitals in the control group. Participants in the project vary from health economists to microbiologists, scientists in motivational research, fitness instructors, clinicians as well as patient organizations such as Gynkreftforeningen (Gynaecological Cancer Patient Organization).