Digital Health for Optimal Supportive Care in Oncology: Benefits, Limits, and Future Perspectives

Abstract

<b>Background:</b> Digital health provides solutions that capture pa­tient-reported outcomes (PROs) and allows symptom monitoring and patient management. Digital therapeutics is the provision to patients of evidence-based therapeutic interventions through software applications aimed at prevention, monitoring, management, and treatment of symptoms and diseases or for treatment optimization. The digital health solutions collecting PROs address many unmet needs, including access to care and reassurance, increase in adherence and treatment efficacy, and decrease in hospitalizations. With current developments in oncology including increased availability of oral drugs and reduced availability of healthcare professionals, these solutions offer an innovative approach to optimize healthcare resource utilization. <b>Design:</b> This scoping review clarifies the role and impact of the digital health solutions in oncology supportive care, with a view of the current segmentation according to their technical features (connection to sensors, PRO collection, remote monitoring, self-management in real time…), and identifies evidence from clinical studies published about their benefits and limitations and drivers and barriers to adoption. A qualitative summary is presented. <b>Results:</b> Sixty-six studies were identified and included in the qualitative synthesis. Studies supported the use of 38 digital health solutions collecting ePROs and allowing remote monitoring, with benefits to patients regarding symptom reporting and management, reduction in symptom distress, decrease in unplanned hospitalizations and related costs and improved quality of life and survival. Among those 38 solutions 21 provided patient self-management with impactful symptom support, improvement of QoL, usefulness and reassurance. Principal challenges are in developing and implementing digital solutions to suit most patients, while ensuring patient compliance and adaptability for use in different healthcare systems and living environments. <b>Conclusions:</b> There is growing evidence that digital health collecting ePROs provide benefits to patients related to clinical and health economic endpoints. These digital solutions can be integrated into routine supportive care in oncology practice to provide improved patient-centered care.

Lifestyle interventions after colorectal cancer surgery using a mobile digital device: A study protocol for a randomized controlled trial

“…To achieve this, an influx of studies has suggested the use of digital devices (internet, smartphones, watches, etc) and many report promising results from this in terms of providing supportive care for cancer patients. [16,17,26] Choosing the most effective modality to collect data is important in this context. Internet-mediated interventions for patients have been reported not to be very effective as there is often a waning adherence to the use of a website over time.…”

“…To achieve this, an influx of studies has suggested the use of digital devices (internet, smartphones, watches, etc) and many report promising results from this in terms of providing supportive care for cancer patients. [16,17,26]…”