Web-Based Patient Self-Reported Outcome After Radiotherapy in Adolescents and Young Adults With Cancer: Survey on Acceptance of Digital Tools (Preprint)

Abstract

BACKGROUND eHealth and mHealth are an evolving trend in the medical field. The willingness to use digital tools is high, and the need is growing. OBJECTIVE Young adults (18-40 years) confronted with a cancer diagnosis present unique needs and require special cancer care. They often have a strong affinity and are familiar with modern technology. On that account, we implemented a web-based symptom and quality of life (QoL) assessment to address patients’ attitudes and willingness to use mHealth tools. The FABIUS trial also aims to evaluate sociodemographic parameters that could influence patients' opinions. METHODS A total of 380 young patients aged from 18-40 years treated with radiotherapy between 2002 and 2017 were included in the trial. We assessed QoL via the EORTC C30 questionnaire and added general questions about mHealth technology. The added questions inquired patients’ opinions regarding general aspects, including technical advances in medicine, mobile, and app assistance during cancer treatment, data transfer, and app-specific features. The survey was conducted for 12 months. Participation was voluntary and pseudonymized; prior written consent was obtained. RESULTS We achieved a participation rate of 57.6% (219/380) and a completion rate of 50.2% (110/219). Median age was 33 years (range: 18-40). Of all participants, 89.1% (98/110) considered new technologies in medicine as positive; 10.9% (12/110) answered with neutral. Nearly all patients (106/110, 96.4%) stated that they would send further data via a web-based platform. Of all, 96.4% considered the provided pseudonymization of their data as safe. We further asked the patients if they would use a mobile app for symptom and QoL assessment similar to the present web-based system: 74.5% (82/110) answered with yes, 25.5% (28/110) would not use a mobile app in the future. Patients are generally positive regarding using an app rated several possible app functions. The three most requested features were: appointment reminders (89.0%, 73/82), contact overview of all involved clinics and physicians (86.6%, 59/82), and transfer of current lab results (86.6%, 59/82). We tested the willingness to use an app on several sociodemographic parameters, such as age, gender, education, health insurance status, and cancer-related parameters: tumor stage, time since radiation treatment, and treatment intention. None of these parameters did correlate with app use in this group of young adults. CONCLUSIONS eHealth and mHealth tools should be available as an integrated part of a comprehensive cancer care approach. It provides automated, thorough documentation of health parameters during therapy and follow-up for doctors, medical staff, and tumor patients to optimize treatment. With the FABIUS trial, we could show that especially the generation of young adults is the ideal patient population to use eHealth/mHealth tools. They offer further digital support and improves their need for constant QoL during cancer care. CLINICALTRIAL n/a