BETRC-Digital

Be Treatment Ready - Colorectal Digital, the development of a digital based healthcare tool for improved nutritional care of people with colorectal cancer receiving chemotherapy treatment.

Study aim

The aim of the BeTR-C DIGITAL study was to develop an acceptable, user friendly and relevant self-management digital resource in the form of an ‘App’ or ‘Application’ called I-EAT, representative of the mantra ‘I Eat to recover from Bowel Cancer’.

Background

Colorectal cancer is a type of bowel cancer that begins in the last part of the digestive tract. Malnutrition is common during chemotherapy treatment for colorectal cancer. It is caused by the disease, its symptoms, and the side effects of treatments. We know that people with good nutritional status during treatment experience less treatment toxicity. They also live longer. In the UK, 16,000 people die from bowel cancer annually. Three in every five people diagnosed with later Stage III-IV disease will receive chemotherapy. Many of them experience malnutrition and they include people who are underweight or overweight.

We wanted to find out if we can support European national guideline recommended oral nutritional intake during chemotherapy for this patient group through the I-EAT resource. These guidelines support nutritional status for good quality of life during cancer treatment and good treatment response with prolonged life. We hoped that in the future patients identified by their hospital healthcare team as having colorectal cancer and being at risk of malnutrition could be signposted to the I-EAT mobile phone or computer-based App at the start of their cancer treatment pathway to encourage patient self-management.

Location South Wales

BeTR-C DIGITAL was run in South Wales, UK. The study was sponsored by Cardiff University, coordinated by the Centre for Trials Research, and funded via a Cardiff University Innovation for All Grant. A Welsh company with a focus on healthcare (Seatstorm) built the I-EAT tool.

Methods

We used findings from our earlier research and systematic literature review to inform the initial I-EAT tool software specification. Followed by co-production methods to develop a prototype and assess user acceptance. Findings from a prioritisation workshop were used to streamline the tool specification and develop the first prototype. The prototype was then user-tested, with findings fed back via a refinement workshop and used to inform development of the final I-EAT software protype.

Results

BeTR-C DIGITAL opened to recruitment on 9 August 2022. The study closed to recruitment 14 December 2022, so it is no longer possible for members of the public or NHS to take part. Workshops were held between October and December 2022. Study analysis and reporting was completed in 2023.

The I-EAT demo tool has multiple features including prompts for when to seek help from a health professional. Dieticians described it as a dynamic self-management tool that complements current clinical practice. Unfortunately, we did not recruit members of the public to our workshops, despite advertising through two separate Welsh public research opportunity schemes and a local hospital site. So there remains a need to evaluate patient acceptance and burden prior to future commercialisation and implementation.

Infographics further describing our findings are available for download in English and Welsh and research and public formats from the document link on this webpage. These include questions raised for future research and how to contact us if you wish to get involved.

We would like to take this opportunity to thank all members of the public and the NHS who have taken part, expressed an interest in taking part, or helped us in any other way to reach this final stage of the study.