Evaluation of an E-Health Program: Results in the Emotional Well-Being of Brazilian Patients With Breast Cancer

Abstract

Objective: The use of e-Health-based technologies has been boosted with COVID-19. This study evaluated the effectiveness of a program developed specifically for women with advanced breast cancer, users of the Unified Health System, in the course of outpatient chemotherapy. Methods: An e-Health program, called Conforto, was developed by a Brazilian group. Patients were followed up on a virtual platform and received psychosocial support via telehealth. In this longitudinal study, female patients diagnosed with locally advanced and metastatic breast cancers (IIIb, IIIc, and IV) undergoing outpatient chemotherapy were recruited. Symptom burden was assessed weekly and the EQ-5D-3L monthly in conjunction with the Perceived General Health (PSG) scale over 6 months with a 2-month follow-up. Results: A total of 71 patients were recruited; 71.8% (n=51) participated for at least 3 months and 39.4% (n=28) participated for 6 months. At baseline, patients had a higher burden of anxiety, distress, and insomnia. The results showed improvement in anxiety (p<0.001), distress (p <0.001), insomnia (p=0.03), sadness (p<0.001), and inappetence (p=0.01). PSG was significantly altered while remaining at follow-up (p=0.006). Most patients (70%), despite not having shown a history of symptoms to the attending physician, spoke with them about the symptoms. Conclusion: To date, this is the first study with e-Health technology developed for Brazilian cancer patients. Routine screening in the virtual modality and telephone service aimed at promoting self-management promotes emotional well-being even in an economically vulnerable population. Although being exploratory data, the findings suggest the effectiveness and feasibility of a sustainable intervention for women with locally advanced and metastatic breast cancers. The results facilitate access to supportive care and thus equity. For better results, it is necessary to include other professionals in the remote monitoring.