Wearable-Based Mobile Health App in Gastric Cancer Patients for Postoperative Physical Activity Monitoring: Focus Group Study

Abstract

Background Surgical cancer patients often have deteriorated physical activity (PA), which in turn, contributes to poor outcomes and early recurrence of cancer. Mobile health (mHealth) platforms are progressively used for monitoring clinical conditions in medical subjects. Despite prevalent enthusiasm for the use of mHealth, limited studies have applied these platforms to surgical patients who are in much need of care because of acutely significant loss of physical function during the postoperative period. Objective The aim of our study was to determine the feasibility and clinical value of using 1 wearable device connected with the mHealth platform to record PA among patients with gastric cancer (GC) who had undergone gastrectomy. Methods We enrolled surgical GC patients during their inpatient stay and trained them to use the app and wearable device, enabling them to automatically monitor their walking steps. The patients continued to transmit data until postoperative day 28. The primary aim of this study was to validate the feasibility of this system, which was defined as the proportion of participants using each element of the system (wearing the device and uploading step counts) for at least 70% of the 28-day study. “Definitely feasible,” “possibly feasible,” and “not feasible” were defined as ≥70%, 50%-69%, and <50% of participants meeting the criteria, respectively. Moreover, the secondary aim was to evaluate the clinical value of measuring walking steps by examining whether they were associated with early discharge (length of hospital stay <9 days). Results We enrolled 43 GC inpatients for the analysis. The weekly submission rate at the first, second, third, and fourth week was 100%, 93%, 91%, and 86%, respectively. The overall daily submission rate was 95.5% (1150 days, with 43 subjects submitting data for 28 days). These data showed that this system met the definition of “definitely feasible.” Of the 54 missed transmission days, 6 occurred in week 2, 12 occurred in week 3, and 36 occurred in week 4. The primary reason for not sending data was that patients or caregivers forgot to charge the wearable devices (>90%). Furthermore, we used a multivariable-adjusted model to predict early discharge, which demonstrated that every 1000-step increment of walking on postoperative day 5 was associated with early discharge (odds ratio 2.72, 95% CI 1.17-6.32; P =.02). Conclusions Incorporating the use of mobile phone apps with wearable devices to record PA in patients of postoperative GC was feasible in patients undergoing gastrectomy in this study. With the support of the mHealth platform, this app offers seamless tracing of patients’ recovery with a little extra burden and turns subjective PA into an objective, measurable parameter.

Physical fitness cognition, assessment, and promotion: A cross-sectional study in Taiwan

“…Generally, medical practitioners are often swamped with clinical responsibilities that they do not have enough time to conduct a routine assessment, discussion, and plan of physical fitness for patients. Fortunately, with information and communication technologies progressing and developing, facilities with internet of things technology such as wearable devices and smartphones have carried out appropriate approaches, along with objective quantitative data, for measurement and management in physical fitness and physical activity [ 59 – 62 ].…”

A Unified Framework for Automatic Detection of Wound Infection with Artificial Intelligence

“…In summary, mHealth is a scalable and flexible platform supporting the practice of medical and perioperative care with the provision of mobile devices [8,[21][22][23], which improve the quality of perioperative care and have proliferated [24,25]. Although some academic centers have developed the mHealth system for postoperative wound care with positive results, it places an additional strain and workload on their provider teams, even if they are enthusiastic about it [5,7,[25][26][27].…”

“…Traditionally, the surgical staff would make a call to inquire the patients of the recovery of the general condition and the wound, whereas the condition of the wound is difficult to be remotely evaluated by verbal communications only. To reduce the gap between home and hospital, mobile health (mHealth) has been created to help patients upload wound images and obtain immediate responses regarding their wound condition and has proved feasible in several studies [6][7][8]. Furthermore, the patients receive feelings of reassurance because the medical staff continuously and seamlessly monitor their recovery.…”

An Image-Based Mobile Health App for Postdrainage Monitoring: Usability Study

“…Among studies focusing on the application of mHealth to surgical issues, several have investigated wound care and pain scaling to validate the clinical usefulness of mHealth [ 54 - 57 ]. A recent study used another wearable device to track the step counts of patients who had undergone various abdominal surgeries for 1 month after discharge and showed that the mHealth app could effectively track recovery [ 24 , 58 ]. Because drain care is an issue that is unique to surgical patients, and telephone conversations and questionnaires cannot be used to access the visual component.…”

“…As the ownership of mobile devices has become more common [ 17 ], patients and their caregivers are increasingly willing to use technology to access health care [ 18 , 19 ]. Several studies have demonstrated that mHealth technology improves the control of cardiac function and glycemic hemostasis, enhances medication compliance, and shortens hospital stays [ 20 - 24 ]. Additionally, prior research on app protocols for surgical patients has focused on routine procedures that already have a low baseline rate of postoperative and discharge complications [ 25 - 27 ].…”