Effectiveness of Internet-based interventions in managing chemotherapy-related symptoms in patients with cancer: a systematic literature review

Moradian, Saeed; Voelker, N; Brown, Catherine; Liu, G; Howell, Doris

doi:10.1007/s00520-017-3900-8

Cited by 58 publications

(64 citation statements)

References 70 publications

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“…The findings described above are in line with a conceptual model where perceived credibility and personal relevance influence engagement [ 36 ]. This study accumulates existing evidence, which imply the need to develop cancer-supportive digital interventions that are interactive and tailored [ 53 ]. Tailoring can be performed by the individual patient before the intervention (pretailoring), by preference to promote autonomy (self-tailoring), and within-person as health status or needs evolve [ 54 ].…”

Section: Discussionmentioning

confidence: 71%

Engagement in an Interactive App for Symptom Self-Management during Treatment in Patients With Breast or Prostate Cancer: Mixed Methods Study

et al. 2020

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Background Using mobile technology for symptom management and self-care can improve patient-clinician communication and clinical outcomes in patients with cancer. The interactive app Interaktor has been shown to reduce symptom burden during cancer treatment. It includes symptom assessment, an alert system for contact with health care professionals, access to self-care advice, and visualization of symptom history. It is essential to understand how digital interventions operate; one approach is to examine engagement by assessing usage and exploring user experiences. Actual usage in relation to the intended use—adherence—is an essential factor of engagement. Objective This study aimed to describe engagement with the Interaktor app among patients with breast or prostate cancer during treatment. Methods Patients from the intervention groups of two separate randomized controlled trials were included: patients with breast cancer receiving neoadjuvant chemotherapy (n=74) and patients with locally advanced prostate cancer receiving treatment with radiotherapy (n=75). The patients reported their symptoms daily. Sociodemographic and clinical data were obtained from baseline questionnaires and medical records. Logged data usage was retrieved from the server and analyzed descriptively and with multiple regression analysis. Telephone interviews were conducted with patients about their perceptions of using the app and analyzed using content analysis. Results The median adherence percentage to daily symptom reporting was 83%. Most patients used the self-care advice and free text message component. Among the patients treated for breast cancer, higher age predicted a higher total number of free text messages sent (P=.04). Among the patients treated for prostate cancer, higher age (P=.01) and higher education level (P=.04), predicted an increase in total views on self-care advice, while higher comorbidity (P=.004) predicted a decrease in total views on self-care advice. Being married or living with a partner predicted a higher adherence to daily symptom reporting (P=.02). Daily symptom reporting created feelings of having continuous contact with health care professionals, being acknowledged, and safe. Being contacted by a nurse after a symptom alert was considered convenient and highly valued. Treatment and time-related aspects influenced engagement. Daily symptom reporting was perceived as particularly meaningful at the beginning of treatment. Requests were made for advice on diet and psychological symptoms, as well as for more comprehensive and detailed information as the patient progressed through treatment. Conclusions Patient engagement in the interactive app Interaktor was high. The app promoted patient participation in their care through continuous and convenient contact with health care professionals. The predictive ability of demographic variables differed between patient groups, but higher age and a higher educational level predicted higher usage of specific app functions for both patient groups. Patients’ experience of relevance and interactivity influenced their engagement positively.

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Section: Discussionmentioning

confidence: 71%

Engagement in an Interactive App for Symptom Self-Management during Treatment in Patients With Breast or Prostate Cancer: Mixed Methods Study

et al. 2020

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“…Earlier systematic reviews and meta‐analyses on digital interventions among cancer patients or survivors have covered information and resources delivery, self‐management of the symptoms, physical activities and healthy living promotion, and social support in different stages of cancer care . In addition, a number of systematic reviews have highlighted the importance of digital interventions in improving cancer screening as well as QoL of cancer caregivers .…”

Section: Introductionmentioning

confidence: 99%

Digital interventions to facilitate patient‐provider communication in cancer care: A systematic review

2020

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Objective: Patient-provider communication is a critical component of cancer care. Digital tools have been applied to facilitate cancer care and patient-provider communication. However, to date, there is no systematic review on this growing body of literature. The objective of this study is to identify the existing digital interventions to improve patient-provider communication among cancer patients and survivors, summarize their characteristics, and synthesize the outcomes of these interventions. Methods: We searched the databases of PubMed, CINAHL, and PsycINFO using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines with the following criteria: (a) empirical studies focusing on digital interventions to facilitate communication between cancer patients or survivors and their health care providers, (b) reporting qualitative or quantitative health outcomes of the cancer patients or survivors after the digital intervention, and (c) English articles published after 2000. Results: The initial literature search generated 1006 articles; only 13 met the inclusion criteria. Most of the studies were conducted among breast, prostate, and lung cancer patients. Ten out of 13 studies used randomized controlled trials to evaluate intervention efficacy. The outcomes assessed included symptoms reporting and management, decision making, distress and quality of life, and utilization of health care. Most studies reported positive outcomes following the interventions. Conclusions: The existing evidence on the number, characteristics, and outcomes of digital interventions to improve patient-provider communication suggests the preliminary efficacy of such interventions. It is essential to develop and implement more evidence-based digital interventions to engage patients, enhance patient-provider communication, and facilitate patient-centered decision making to improve patientcentered health outcomes, especially in underserved communities of cancer patients and survivors. K E Y W O R D S cancer patients, cancer survivors, digital intervention, patient-provider communication, review

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“…There is growing evidence in support of using patient-reported outcome measures (PROMs) for improving symptom management [3-5]. The increased number of mobile phone users creates opportunities for developing models of supportive care that use these technologies for monitoring PROMs to improve home-based, proactive “real-time” symptom monitoring and management [6-8]. Several Web-enabled PROMs systems have been trialed in oncological settings [4,8-10] and shown to support patients in managing chemotherapy-related symptoms [3,11], improve symptom control [11,12], and enhance patient-clinician communication [4].…”

Section: Introductionmentioning

confidence: 99%

Usability Evaluation of a Mobile Phone–Based System for Remote Monitoring and Management of Chemotherapy-Related Side Effects in Cancer Patients: Mixed-Methods Study

Moradian¹,

Krzyzanowska²,

Maguire³

et al. 2018

JMIR Cancer

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BackgroundAs most chemotherapy is administered in the outpatient setting, patients are required to manage related side effects at home without direct support from health professionals. The Advanced Symptom Management System (ASyMS) has been developed to facilitate the remote monitoring and management of chemotherapy-related toxicity in patients with cancer, using patient-reported outcomes questionnaires and a clinician alerting system.ObjectiveThis study aims to evaluate the usability of the ASyMS, a mobile phone–based technology, from the perspective of Canadian patients with cancer receiving chemotherapy to identify existing design, functionality, and usability issues and elicit their views, experiences, and satisfaction with the ASyMS.MethodsWe used a mixed-method approach to data collection with user-based testing, a think-aloud technique, semistructured interviews, and short answer questionnaires with a purposive sample of 10 patients with cancer. Participants attended usability testing sessions at the Centre for Global eHealth Innovation, University Health Network, and performed specific tasks on the ASyMS device. The test was videorecorded and each task was timed during the test. After the usability sessions, participants completed a posttest questionnaire and participated in a semistructured qualitative interview. A thematic analysis was used to code and categorize the identified issues into themes that summarized the type and frequency of occurrence.ResultsThe thematic analysis generated 3 overarching themes as follows: ASyMS user-friendliness; usefulness of ASyMS (content quality and richness); and intention to use. Results from the posttest questionnaire indicated that 80% (8/10) of participants had great motivation to use the ASyMS, 70% (7/10) had positive perceptions of the successful use of the ASyMS, and all (10/10, 100%) had a positive attitude toward using the ASyMS in the future. Most identified design and functionality issues were related to the navigation of the ASyMS device and a desire for a more attractive design with advanced functionality and features. The main general design recommendations were as follows: enhance the readability of the screen; implement advance options (eg, search option); and support better navigation.ConclusionsThe ASyMS has shown positive perceptions of patients in usability testing and qualitative interviews. An evaluation of the effects of the ASyMS on symptom outcomes in a clinical trial is needed.

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Effectiveness of Internet-based interventions in managing chemotherapy-related symptoms in patients with cancer: a systematic literature review

Abstract: Despite the evidence in support of using the Internet as a worthwhile tool for effective patient engagement and self-management of chemotherapy-related symptoms outside clinic visits, methodological limitations in the evidence base require further well-planned and quality research.

Cited by 58 publications

References 70 publications

Engagement in an Interactive App for Symptom Self-Management during Treatment in Patients With Breast or Prostate Cancer: Mixed Methods Study

Engagement in an Interactive App for Symptom Self-Management during Treatment in Patients With Breast or Prostate Cancer: Mixed Methods Study

Digital interventions to facilitate patient‐provider communication in cancer care: A systematic review

Usability Evaluation of a Mobile Phone–Based System for Remote Monitoring and Management of Chemotherapy-Related Side Effects in Cancer Patients: Mixed-Methods Study

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