A Mobile App for Thyroid Cancer Patients Aiming to Enhance Their Quality of Life: Protocol for a Quasiexperimental Interventional Pilot Study

Abstract

Background Thyroid cancer (TC) is one of the fastest growing cancers all over the world. Differentiated thyroid cancer (DTC) is the most frequent subtype of TC. When appropriate treatment is given, the prognosis for the patient is generally excellent. Despite the generally good prognosis of thyroid carcinomas, the symptoms may range from emotional to physical discomfort, depending on the thyroid hormone status, which can severely affect the patient. Moreover, the diagnostic and therapeutic procedures that DTC patients have to undergo, such as thyroidectomy and radioiodine therapy, significantly affect their mental and physical well-being. Often, the physician only addresses the favorable prognosis of DTC compared with other cancer types and neglects to assess issues related to the quality of life (QoL) of the patient; this was the reason we decided to design a mobile app for DTC patients and their caregivers. Objective The aim of this study is to research the feasibility and applicability of an mHealth app tailored to DTC patients, as reflected in their QoL. The main features of the developed app offer access to useful information about thyroid cancer, diagnostic tests, and the appropriate therapy administered to DTC patients. Methods Based on the existing literature, we created an up-to-date information platform regarding TC and especially DTC. In order to develop an effective app that can be implemented in current health care, we designed a section where the patient and physician can keep a medical record in an effort to enable access to such information at any time. Finally, we designed a user-friendly notification program, including pill prescription, follow-up tests, and doctor visit reminders in order to equally facilitate the lives of the patient and physician. Results Having developed this mobile app, we aim to conduct a pilot quasiexperimental interventional trial. Our intention is to enroll at least 30 TC patients and assign them to intervention or control groups. Both groups will receive standard care for treating and monitoring TC, and the intervention group will also receive and use the DTC app. TC patients’ QoL will be assessed for both control and intervention groups in order to examine the effectiveness of the DTC app. QoL will be assessed through the QoL core questionnaire European Organisation for Research and Treatment of Cancer (EORTC) QLQ-THY34 in combination with the EORTC QLQ-C30 questionnaire through quantitative statistical analysis. Conclusions The use of mHealth apps can play a significant role in patient education, disease self-management, remote monitoring of patients, and QoL improvement. However, the main limitation of the majority of existing studies has been the lack of assessing their usefulness as well as the absence of specific instruments to carry out this assessment. In light of those considerations, we developed a mobile app tailored to the needs of DTC patients. Furthermore, we evaluated its contribution to the QoL of the patients by using the EORTC QLQ-THY34 questionnaire, an accurate and safe instrument for the evaluation of the QoL in TC patients, while supporting future planned endeavors in the field. International Registered Report Identifier (IRRID) PRR1-10.2196/13409

Evaluating Barriers and Facilitators to the Uptake of mHealth Apps in Cancer Care Using the Consolidated Framework for Implementation Research: Scoping Literature Review

“…The 91 studies included for analysis describe 73 mHealth apps, of which 29 (40%) were designed for supporting any cancer types [ 9 , 12 , 47 , 48 , 50 , 54 , 56 - 58 , 65 - 69 , 71 , 73 , 74 , 76 , 81 - 83 , 85 - 88 ,​ 90 , 91 , 93 , 105 - 109 , 111 - 113 , 116 , 117 , 121 , 122 , 125 , 128 ], followed by 17 (23%) on breast cancer [ 49 , 64 , 70 , 72 , 77 ,​ 78 , 80 , 95 - 98 , 103 , 114 , 115 , 118 , 124 , 126 , 129 - 131 ], 5 (7%) [ 52 , 53 , 63 , 99 , 101 , 102 ] on gastric and colon cancer types, 3 (4%) [ 75 , 79 , 89 , 119 ] on lung cancer, 3 (4%) on thyroid cancer [ 84 , 100 , 123 ] type, and 2 (3%) on hematological cancer types [ 9 , 55 , 56 ,…”

“…Of the 91 studies, 78 (86%) [8,9,12,16, were research articles, whereas 13 (14%) [119][120][121][122][123][124][125][126][127][128][129][130][131] Owing to their heterogeneous nature, the selected articles had different study durations, ranging from 2 weeks for small-scale trials to up to 2 years for larger-scale RCTs. The median sample size of the study participants was 51, ranging from a minimum of 5 to a maximum of 4475 patients.…”

“…,45,59,60,66-69,75,81,89,102,106,107,113,125], which included several treatment types, such as a combination of chemotherapy and radiotherapy. Nonpharmacological treatments include surgery (8/73, 11%)[8,49,61,79,96,109,123,130] and transplantation (3/73, 4%)[77,97,100,103]. mHealth users can be patients, clinicians, a broader pool of health care professionals (HCPs), or different combinations of users.…”

“…mHealth users can be patients, clinicians, a broader pool of health care professionals (HCPs), or different combinations of users. Most commonly, apps are designed for both patients and clinicians (42/73, 58%)[12,16,[48][49][50][51][52][53][54][55]58,59,61,63,66,67,69,75,77,[84][85][86]89,[91][92][93][94]96,98,100,101,[104][105][106]108,110,[112][113][114][115][116]119,120,[122][123][124][125][127][128][129]…”

“…55,57-63,65,67,70,71,73-87,90-92, 94-104,107-116,119-122,128-131], 37 in Global quality of life[8,57,60,62,64,65,68,72,75,78,84,86,[88][89][90][91]93,97,101,103,105,106,112,114,115,[119][120][121][123][124][125][126][127][128][129][130][131], 16 in Emotional functioning and well-being[66,70,77,83,89,90,93,106,115,119,[125][126][127][128]…”