Use of mobile device technology to continuously collect patient-reported symptoms during radiation therapy for head and neck cancer: A prospective feasibility study

Abstract

PurposeAccurate assessment of toxicity allows for timely delivery of supportive measures during radiation therapy for head and neck cancer. The current paradigm requires weekly evaluation of patients by a provider. The purpose of this study is to evaluate the feasibility of monitoring patient reported symptoms via mobile devices.Methods and materialsWe developed a mobile application for patients to report symptoms in 5 domains using validated questions. Patients were asked to report symptoms using a mobile device once daily during treatment or more often as needed. Clinicians reviewed patient-reported symptoms during weekly symptom management visits and patients completed surveys regarding perceptions of the utility of the mobile application. The primary outcome measure was patient compliance with mobile device reporting. Compliance is defined as number of days with a symptom report divided by number of days on study.ResultsThere were 921 symptom reports collected from 22 patients during treatment. Median reporting compliance was 71% (interquartile range, 45%-80%). Median number of reports submitted per patient was 34 (interquartile range, 21-53). Median number of reports submitted by patients per week was similar throughout radiation therapy and there was significant reporting during nonclinic hours. Patients reported high satisfaction with the use of mobile devices to report symptoms.ConclusionsA substantial percentage of patients used mobile devices to continuously report symptoms throughout a course of radiation therapy for head and neck cancer. Future studies should evaluate the impact of mobile device symptom reporting on improving patient outcomes.

Electronic patient-reported outcomes from home in patients recovering from major gynecologic cancer surgery: A prospective study measuring symptoms and health-related quality of life

“…Additional work must be done to improve clinician satisfaction, and to determine the system’s usefulness and its optimal incorporation into clinical practice. Electronic methods of capturing PROs have also been reported in the inpatient setting, and in the use of mobile devices [14, 18]. Further research should focus on the utility of these interventions in assessing patient recovery after major gynecologic surgery.…”

Innovations in research and clinical care using patient‐generated health data

“…Mixed findings may be because of high study heterogeneity in terms of remote monitoring methodology, patient‐provider communication, and the patient population. Remote monitoring methodology has included study‐initiated calls from an automated telephone system, 79 patient‐initiated calls to an automated telephone system, 77,80,84 study‐initiated online questionnaires, 24,81 patient‐initiated smartphone‐based or online questionnaires, 82,86 study‐initiated telephone calls from a nurse or nurse practitioner, 83,85 study‐initiated calls from a research coordinator, 87 or a paper symptom diary 78 . Some studies incorporated automated alerts about severe or worsening symptoms to providers, 77,79,80,82,84,88 whereas others encouraged patients to discuss symptoms with their providers 78 .…”

“…Taken together, these data suggest that thoughtfully designed remote symptom monitoring interventions may improve outcomes in patients with cancer. In addition, numerous studies have shown that remote symptom monitoring is feasible and acceptable to patients and providers 80,84,86,88‐93 . However, more work is clearly needed to identify characteristics of health systems, patient populations, and intervention designs to ensure that remote symptom monitoring is maximally efficacious 94,95 …”

Patient Use of Electronic Methods to Self-Report Symptoms: An Integrative Literature Review

“…PALM: In the Blum et al (2014) study, 49% of the 84 participants preferred the PALM (handheld computer) to the paper-based assessment. Several studies reported high patient acceptability and feasibility regarding the electronic assessment of symptoms (Abernethy et al, 2008;Andikyan et al, 2012;Basch et al, 2007;Blum et al, 2014;Chan et al, 2011;Falchook et al, 2016;Wintner et al, 2015;Wolpin et al, 2008;Wu et al, 2016). Three studies (Head et al, 2009;Mirkovic, Kaufman, & Ruland, 2014;Ruland, Maffei, et al, 2013) considered the usability and usefulness of a device from the patient's perspective.…”