Digital Follow-Up and the Perspective of Patient-Centered Care in Oncology: What’s the PROblem?

Giordano, Frank A.; Welzel, Grit; Siefert, V.; Jahnke, L.; Ganslandt, Thomas; Wenz, Frederik; Grosu, Anca‐Ligia; Heinemann, F.; Nicolay, Nils H.

doi:10.1159/000495294

Cited by 24 publications

(14 citation statements)

References 40 publications

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“…Medical science and practice has started acknowledging this challenge and has developed several important advances to improve patient-oriented clinical decision-making. This includes, for example, the increased use of patient-reported outcomes [17,18,52], which have been shown to increase the implementation of shared decision-making and can serve as a basis for clinical decision support systems [53]. Another approach that has been shown to improve decision-making is the use of patient decision aids [17,18].…”

Section: Discussionmentioning

confidence: 99%

Emotions as Social Information in Shared Decision-Making in Oncology

Treffers

Putora

2020

Oncology

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Emotions play an important role in decision-making and they can impact individual as well as shared decisions. With increasing complexity of the decision, the potential for emotions to influence the outcome increases. Emotions are thus an influential factor in oncological decision-making which is a complex and high-stakes situation. As the shared decisionmaking process is at the center of patient-centric decisions, we model emotions as social information that inform the shared decision-making process. We present and explain a range of emotional concepts, together with a specific clinical example, that can impact the shared decision-making process. Our process model shows that emotions are experienced in various combinations before, during, and after a shared decision is made and how patients' and physicians' emotions interact and spill over during a shared decision situation. Overall, our process model and specific example show how emotions can impact shared decision-making in oncology in a multitude of ways. With this paper, we want to raise awareness of the role of emotions in the shared decision-making process, as emotions are often not explicitly recognized as decision criteria. Increased awareness of emotions may help their optimal utilization and reduce their influence as a bias in shared decision-making.

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Section: Discussionmentioning

confidence: 99%

Emotions as Social Information in Shared Decision-Making in Oncology

Treffers

Putora

2020

Oncology

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“…A prerequisite for successful implementation of this technology into clinical routine is a high level of usability of devices to sustain their usage. There is increasing evidence that usage of wearables and mobile applications to report symptoms in cancer patients in general is feasible [10,11]. Palliative cancer patients experience more and worse symptoms than cancer patients treated in a curative setting and are therefore often considered too burdened to deal with a new technology [12].…”

Section: Introductionmentioning

confidence: 99%

Feasibility and Usability Aspects of Continuous Remote Monitoring of Health Status in Palliative Cancer Patients Using Wearables

Pavic¹,

Theile²,

Kraft³

et al. 2019

Oncology

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Background: Mobile health is a promising strategy aiming to anticipate and prevent the deterioration of health status in palliative cancer patients. A prerequisite for successful implementation of this technology into clinical routine is a high level of usability and acceptance of devices. Objectives: We aimed to evaluate feasibility as well as patients' acceptance of remote monitoring using wearables in palliative cancer patients. Methods: In this prospective single-center observational feasibility study, 30 cancer patients treated with palliative intent in an inpatient setting with an estimated life expectancy of > 8 weeks and < 12 months were provided with a smartphone including a pre-installed "Activity Monitoring" app and a sensor-equipped bracelet and monitored over a period of 12 weeks starting at discharge from hospital. We report detailed feasibility and usability aspects and comment on patients' acceptance of the wearables. Results: Between February 2017 and May 2018 a total of 30 patients were included in the study. From these, 25 participants (83%) completed the whole study period. On average, the bracelet was worn on 53% and smartphone used on 85% of the study days. The completion rate of daily digital questionnaires for subjective ratings (pain and distress scale) was 73%, and 28 patients were able to handle the wearables and to operate the app without major problems. Use of the bracelet was low during the night hours, with a wearing time of 1.7% of all night hours (8 p.m. to 8 a.m.). Conclusions: Remote monitoring of health care status in palliative cancer patients with a limited life expectancy is feasible and patients are able to handle the smartphone and the sensor-equipped bracelet. Feedback towards use of this monitoring system was mostly positive.

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“…The paper in this issue by Giordano [1] describes the current state of mobile health in oncology, a big part of which are electronic patient-reported outcomes. The most impressive results are reported in two prospective randomized trials by Basch et al [2] and Denis et al [3] demonstrating a survival benefit with electronic patientreported outcome measures (ePROMs).…”

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confidence: 99%

“…Whether we are ready to declare the use of ePROMs a standard of care is up for debate -several barriers and limitations are addressed in the paper by Giordano [1]. Going forward, we will need to learn how to apply this new modality and understand how to compare and combine approaches.…”

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confidence: 99%