Are All Societies Ready for Digital Tools? Feasibility Study on the Use of Mobile Application in Polish Early Breast Cancer Patients Treated with Perioperative Chemotherapy

Abstract

Background: The population of individuals affected by breast cancer is growing, and with advances in cancer treatment implemented into usual care, there is an urgent need to improve the recognition, monitoring and treatment of therapy-induced adverse effects. This study aims to explore the use of an in-app electronic questionnaire to assess and monitor chemotherapy-related symptoms in early breast cancer patients treated with perioperative chemotherapy. Method: Between December 2019 and June 2021, 72 female study participants used the mobile app Centrum Chorób Piersi UCK and completed an in-app questionnaire about the 14 most common chemotherapy-related symptoms. Replies including symptoms with a critical value triggered automatic email alerts to the nursing team. Results: Acceptance of the study was higher among younger women and patients originating from rural areas, while possible digital exclusion among patients >60 years was observed during the enrolment process. A total of 55 participants completed the electronic questionnaire at least once and generated 553 responses with 1808 specific problems reported. Fatigue (n = 428) was the most common problem, and fever (n = 5) the least reported problem. A total of 21 participants triggered alerts with responses containing symptoms with critical value assessment (n = 89). Significant negative correlation was observed between the number of responses and time from the first chemotherapy administration; however, the number of responses was not determined by any sociodemographic or medical factors. Significant positive correlations were identified between the number of communicated problems and participants’ age. The usage of our electronic symptom assessment questionnaire decreased substantially after the period of active encouragement during the study enrolment. Conclusions: Not all societies are ready for innovative eHealth solutions. Patients’ age should be carefully considered when app-based interventions are introduced to usual cancer care. Additional support is suggested for older patients to improve their awareness and participation in eHealth interventions. More research involving older participants is needed to explore and address their particular needs and perspectives on eHealth solutions.

Involving Patients and Clinicians in the Design of Wireframes for Cancer Medicines Electronic Patient Reported Outcome Measures in Clinical Care: Mixed Methods Study

“…Similarly, patients in this study reported that using a digital solution for collecting ePROMs would be acceptable as part of routine care. Previous evidence has shown that collecting PROMs in routine care could help bring key issues to the fore [15][16][17][45][46][47][48]. Furthermore, in this study, ePROMs were seen as potentially valuable in terms of contributing to the wider evidence base, as reported previously [47].…”

“…Nevertheless, this did not appear to impact the perceived usefulness of the clinician dashboard. Second, patients' age was suggested as a possible barrier to use by some clinicians, as articulated in previous studies [17,20,46,48]. However, despite suggesting changes relating to the accessibility of the app, other clinicians as well as patients (median age of 67 years) indicated they would use the technology and did not report age as a barrier.…”

Guidance on mucositis assessment from the MASCC Mucositis Study Group and ISOO: an international Delphi study

“…Certainly, some tools offer unique capabilities in branching logic to eliminate unnecessary questions and optimize the experience for the user. 32 , 33 However, our results show that only a minority use digital tools in assessing mucositis, citing the lack of universally accepted tools as the main barrier (39% of respondents), followed by cost (23%), lack of appropriate infrastructure (22%), lack of literature (20%), patient hesitancy (15%) and time (12%). This is not surprising, as not every medical community is prepared for advanced digital tools and parameters such as the patient's age/technical literacy should be carefully taken into consideration.…”

“…This is not surprising, as not every medical community is prepared for advanced digital tools and parameters such as the patient's age/technical literacy should be carefully taken into consideration. 32 However, patients that use digital health tools can become more independent, proactive and accepting of themselves. 33 Further research is needed to explore the added benefit of digital tools in assessing mucositis, and societal leadership is needed to identify the desirable attributes of such platforms both in their design, development and implementation.…”