Supportive Care in Radiotherapy Based on a Mobile App: Prospective Multicenter Survey

Abstract

BackgroundConsumer electronics and Web-enabled mobile devices are playing an increasing role in patient care, and their use in the oncologic sector opens up promising possibilities in the fields of supportive cancer care and systematic patient follow-up.ObjectiveThe objective of our study was to assess the acceptance and possible benefits of a mobile app–based concept for supportive care of cancer patients undergoing radiotherapy.MethodsIn total, 975 patients presenting for radiotherapy due to breast or prostate cancer were screened; of them, 200 owned a smartphone and consented to participate in the survey. Patients were requested to complete a questionnaire at 2 time points: prior to the initiation (T0) and after the completion (T1) of radiotherapy. The questionnaire included questions about the habits of smartphone usage, technical knowledge and abilities of the participants, readiness to use a mobile app within the context of radiotherapy, possible features of the mobile app, and general attitude toward the different aspects of oncologic treatments. For quantitative analysis, sum scores were calculated for all areas of interest, and results were correlated with patient characteristics. Additionally, answers were quantitatively compared between time points T0 and T1.ResultsMedian patient age was 57 (range 27-78) years. Of the 200 participants, 131 (66.2%) reported having the ability to use their smartphones with minimal to no help and 75.8% (150/200) had not used their smartphones in a medical context before. However, 73.3% (146/200) and 83.4% (166/200) of patients showed a strong interest in using a mobile app for supportive care during radiotherapy and as part of the clinical follow-up, respectively. Patients most commonly requested functionalities regarding appointment scheduling in the clinic (176/200, 88.0%) and the collection of patient-reported outcome data regarding their illness, therapy, and general well-being (130/200, 65.0%). Age was identified as the most influential factor regarding patient attitude, with patients aged <55 years being significantly more inclined toward and versed in smartphone use (P<.001). The acceptance of mobile apps was significantly higher in patients exhibiting a Karnofsky performance index <80% (P=.01). Support in the context of therapy-related side effects was judged most important by patients with poor clinical performance (P=.006). The overall acceptance of mobile apps in the context of radiotherapy surveillance was high at a median item sum score of 71.4/100 and was not significantly influenced by tumor stage, age, gender, treatment setting, or previous radiotherapies.ConclusionsThe acceptance of mobile apps for the surveillance and follow-up of cancer patients undergoing radiotherapy is high; this high acceptance level will serve as a basis for future clinical trials investigating the clinical benefits of mobile app–based treatment support. Introduction of mobile apps into the clinical routine should be considered as an opportunity to improve and intensify supportive ...

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

“…Furthermore, we did not evaluate reasons for the acceptance of wearables or patients' expectations on the impact of such devices. El Shafie et al [25] performed a survey evaluating the acceptance and expectations of use of a mobile app in breast and prostate cancer patients undergoing radiation therapy. A large proportion (> 70% of patients) showed strong interest in using a mobile app during radiotherapy and clinical follow-up.…”

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

“…A survey among 108 oncologists and nurses reported that more than 80% of health care providers deemed app-based PRO reporting as useful as part of complimentary oncological surveillance [24]. Patients seemed slightly more reluctant to share their medical data with between half and two thirds of patients willing to report PROs online [25,26]. Only few clinical factors seem to influence the willingness of patients to use mobile device-based PRO reporting, including a younger age and a reduced performance status while gender, tumour stage, histology and type of treatment did not have any significant effects [26].…”

“…Patients seemed slightly more reluctant to share their medical data with between half and two thirds of patients willing to report PROs online [25,26]. Only few clinical factors seem to influence the willingness of patients to use mobile device-based PRO reporting, including a younger age and a reduced performance status while gender, tumour stage, histology and type of treatment did not have any significant effects [26]. Early feasibility studies confirmed overall compliance levels of around 50% in cancer patients using mobile PRO reporting, although adolescents and patients from countries with an advanced technological infrastructure have been found to exhibit higher rates of up to 80% [27][28][29].…”

“…Beyond patient compliance, patient ability to access and use mobile technology may also pose a major challenge for mobile PRO reporting. The availability of mobile devices among cancer patients has been reported to range between 70 and 80% [25,26]; however, this patient cohort contains a considerable percentage of elderly patients that may not have access to mobile technology. In order to accommodate these patients, web-based platforms and the recruitment of family members and relatives for the collection and reporting of PROs have been used as alternative means in prospective trials [4,8].…”

Oncology Informatics: Status Quo and Outlook

“…With the spread of mobile technology, structured high-quality data (electronic patient-reported outcomes) can be submitted from the patients themselves and become directly integrated into their records [18]. It has been demonstrated that this is feasible in a general population [19][20][21], and the acceptance rates of such solutions both on the patient side and the side of healthcare providers appear high. Electronic patient-reported outcome measures (ePROMS) enable structured first-hand data and open up the possibility to analyse the psychophysiological background of a reported incident as patient-centred IT may soon be able to connect such reports with measurements from miniature, wearable sensors and devices [22].…”