Effects of digital stress-management interventions in breast cancer patients 18 months after intervention access.

In 30 seconds

This randomized controlled trial examined whether app-based cognitive behavioral (CBI) or mindfulness-based (MBI) stress management was associated with improved outcomes 18 months after access began among patients with breast cancer. Of 430 participants randomized to CBI, MBI, or usual care, 327 (76%) completed the 18-month survey. Neither intervention group had a statistically significant improvement in perceived stress or secondary outcomes compared with usual care. Exploratory subgroup findings indicated greater stress reduction among participants aged ≤50 years in both intervention groups, while higher baseline stress predicted greater reduction overall; the moderator effect was significant only for CBI.

Key findings

• At 18 months, neither CBI nor MBI differed significantly from usual care in perceived stress or secondary outcomes.
• Participants aged ≤50 years showed greater stress reduction with both CBI and MBI than with usual care.
• Higher baseline stress predicted greater stress reduction in the total sample; the moderator effect was significant only in the CBI group.
• Of 430 randomized participants, 327 (76%) completed the 18-month survey.

Why it matters

The findings temper expectations that extended access to digital stress-management programs produces broad, sustained benefits for patients with breast cancer. The subgroup results suggest that age and initial stress may be relevant when interpreting response, but they do not establish who will benefit or demonstrate an overall intervention effect. These distinctions matter when considering digital programs as supportive care.

What to keep in mind

The 18-month survey was completed by 76% of randomized participants, and the overall comparisons showed no significant intervention benefit. Subgroup findings should be interpreted cautiously.