Women with metastatic breast cancer don't just follow step-count trends, they exceed them: an exploratory study.

PURPOSE: Metastatic breast cancer (MBC) patients are living longer at the cost of several side effects, affecting their physical and mental health. Physical activity can help women with MBC to improve their wellbeing. Technology-based exercise interventions have shown promising outcomes; however, studies that document their benefits on health behaviors are lacking. Therefore, we aimed to document the impact of virtual assistant technology on enhancing daily step counts in women with MBC. METHODS: A total of 38 women with MBC participated in the 90-day Nurse AMIE (Addressing Metastatic Individuals Everyday) for Amazon Echo Show study, an artificial intelligence-based supportive care intervention. Each day, Nurse AMIE asked four symptom questions (sleep, pain, fatigue, and distress) and daily step counts. Based on participants' answers, an algorithm provided an activity to assist with symptom management. RESULTS: During the first week of the intervention, mean step counts per day were 4935 ± 2884, and during the last week of the intervention, mean step counts per day were 1044 steps higher, for an average of 5979 ± 2651 steps. Non-significant differences were observed between the first and last week (p = 0.211) and between the first and last day (p = 0.099), despite an improvement of 21.2% over time and significant differences between baseline and the other days. CONCLUSION: Women with MBC benefited from the Nurse AMIE for Amazon Echo Show intervention. Despite improvements over time (> 20%), we cannot conclude that the intervention significantly enhanced participants' daily step counts. Larger studies using virtual assistant technologies are required, and this study should be considered a first step in this direction.

Addressing metastatic individuals everyday: Rationale and design of the nurse AMIE for Amazon Echo Show trial among metastatic breast cancer patients.

Background: Metastatic Breast Cancer (MBC) patients often feel their symptom-related needs are unmet, despite visiting their doctors up to once a week. Novel approaches are needed to address symptoms without requiring additional appointments. Technology based symptom management approaches to address symptoms have not been well tested. Methods: Nurse AMIE (Addressing Metastatic Individuals Everyday) is a technology based supportive care platform that provides guideline-concordant symptom management interventions in response to patient reported symptoms. We have previously successfully implemented a tablet version of Nurse AMIE. However, some eligible patients chose not to participate because they were overwhelmed by the technology. To address this barrier, we translated the Nurse AMIE platform to the Amazon Echo Show, which allowed for voice-based interactions. Forty-two MBC patients were randomized 1:1 to receive the Nurse AMIE for Echo Show immediately for six months, or to receive the same intervention for three months, after a three month delay. The primary outcome was change in physical distress over three months, and secondary outcomes included feasibility, acceptability, patient reported outcomes and usability. Conclusions: Results from the Nurse AMIE for Echo Show trial will identify the feasibility, acceptability, and preliminary effects of the Nurse AMIE for Echo Show on patient reported outcomes. Untested novel technologies, particularly voice-based artificial intelligence devices may an effective and scalable vehicle through which we can deliver supportive care interventions. Clinicaltrialsgov identifier: NCT04673019.