Hong Kong’s SUPPORT+ App Cuts Unplanned Hospitalizations Among Cancer Patients

The study, published in JAMA Network Open, found that 17.2% of patients using the SUPPORT+ app experienced unplanned hospital admissions, compared with 28.5% of those receiving usual care alone.

A mobile app developed by the University of Hong Kong (HKU) reduced unplanned hospital admissions among patients with advanced cancer receiving home-based palliative care, according to a randomized controlled trial involving 1,214 patients.

The study, published in JAMA Network Open, found that 17.2% of patients using the SUPPORT+ app experienced unplanned hospital admissions, compared with 28.5% of those receiving usual care alone. Patients in the app group also spent fewer days in the hospital, averaging 3.4 days compared with 7.3 days in the control group.

Developed by the HKU Li Ka Shing Faculty of Medicine (HKUMed), SUPPORT+ enables patients and caregivers to monitor symptoms, access self-management advice, and receive nurse-led support when symptoms worsen.

How SUPPORT+ Supports Palliative Care

The app allows users to record physical and psychological symptoms and rate their severity using a standardized scale. When symptoms cross predefined thresholds, the system provides tailored educational guidance and alerts the nursing team for follow-up.

Nurses review reported symptoms alongside relevant medical records and contact patients or caregivers by telephone to assess their condition, offer advice, and determine whether further intervention or referral is necessary.

The app also provides information on cancer management, palliative care, and end-of-life services, and incorporates the Integrated Palliative Outcome Scale to assess care outcomes.

Clinical Trial Findings

The trial was conducted between January 2023 and February 2025 across six public hospitals in Hong Kong. Of the 1,214 participants, 590 received SUPPORT+ alongside usual care, while 624 received usual care alone. Researchers followed both groups for 18 weeks.

Beyond reducing hospital admissions and inpatient stays, SUPPORT+ users maintained better health-related quality of life and greater confidence in managing symptoms. Self-efficacy scores remained stable in the app group but declined among patients receiving usual care alone.

However, researchers found no statistically significant differences in emergency department visits or overall survival between the groups.

Study lead Wendy Chan Wing-lok, clinical associate professor at HKUMed, said nursing support was an important component of the intervention. Nurses assess symptoms, provide psychosocial and emotional support, and help families determine whether patients require hospital care or can safely manage symptoms at home.

Expansion Beyond Palliative Care

SUPPORT+ has been under development since 2021 and has recorded approximately 76,000 downloads, reaching more than 2,800 patients and family members. The initiative is funded by the Bank of China (Hong Kong) Centenary Charity Programme, while the clinical trial received support from the Hong Kong government’s Health and Medical Research Fund.

The HKUMed team has begun expanding the app’s use to patients aged 65 and older starting new anticancer treatments. Researchers also plan to introduce it at additional public and private hospitals and community palliative care services across Hong Kong.

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