Ambulant monitoring and web-accessible home-based exercise program during outpatient follow-up for resected lung cancer survivors: actual use and feasibility in clinical practice

Abstract

PurposeThe aim of this study is to evaluate the feasibility of a telehealthcare application for operable lung cancer (OLC) patients, consisting of ambulant symptom and physical activity monitoring (S&PAM) and a web-accessible home-based exercise program (WEP), and identify possible barriers for successful adoption and implementation.MethodsA two-stage mixed methods design was used, in which 22 OLC patients and their treating healthcare professionals (HCPs) participated from pre-surgery to three (stage 1; n = 10) or six (stage 2; n = 12) months post-surgery. Actual use and acceptability (usability, usefulness, and satisfaction) were evaluated.ResultsSeventeen OLC patients (age (SD): 59 (8) years; 8 female) actively used the modules. S&PAM use varied from 1 to 11 monitoring days prior to outpatient consultations. Patients used WEP most frequently during the first 5 weeks, with an average of four logins a week. Fifty-eight percent used WEP beyond 7 weeks. No adverse situations occurred, and patients felt confident using the applications.Perceived added value included active lifestyle promotion, decreased anxiety, and accessibility to specialized HCPs. Physiotherapists used WEP as intended. Contrarily, physicians scarcely used information from S&PAM. To promote future adoption, strategies should focus on high-level patient tailoring of the technology, and formalization of including the applications in the clinical workflow.ConclusionsAmbulant monitoring and web-accessible home exercise is clinically feasible for OLC patients. However, low level of adoption by referring physicians may hamper successful implementation.Implications for cancer survivorsPatients perceived both ambulant monitoring and web-accessible exercise as an added value to regular care and feasible to use in the period before and after lung resection.Electronic supplementary materialThe online version of this article (doi:10.1007/s11764-017-0611-6) contains supplementary material, which is available to authorized users.

Determinants of adherence to physical cancer rehabilitation guidelines among cancer patients and cancer centers: a cross-sectional observational study

“…PCRPs delivered through practical avenues such as print materials, telephone counseling, and web-based programs are an alternative [125][126][127][128][129] for patients with fewer visits to the cancer center. Web-based PCRPs with online encouragement, online diaries, and online physical activity programs proved to be feasible with median vigorous PAU over time, and the burden for HCPs appeared to be limited [130][131][132].…”

Supporting Lung Cancer Patients With an Interactive Patient Portal: Feasibility Study

“…eHealth in lung cancer patients is a relatively new occurence, and few studies have been published. Most of these studies are related to symptom monitoring [ 7 , 8 , 10 , 11 ], which is very different from our multicomponent intervention. One study by Gustafson et al [ 9 ] reported the results of a trial in which they compared the use of a comprehensive online intervention (Comprehensive Health Enhancement Support System [CHESS]) with standard Internet access in palliative lung cancer patients and especially their caregivers.…”

Introduction to special section on digital technology and cancer survivorship

“…Roberts et al [5] also conclude that improved understanding of strategies for enhancing patient engagement with digital interventions to help maintain adherence is necessary. This is a salient issue within the exercise intervention feasibility studies provided by Timmerman et al [6] (lung cancer survivors) and Harder et al [7] (breast cancer survivors) where the value of putting patient user input at the centre of the design and assessment of digital interventions is clearly demonstrated. We are pleased to include these studies as they also reveal the extent of developmental work required to design and implement electronically supported interventions.…”