mHealth program for patients with advanced cancer receiving treatment in a public health hospital in Brazil

Abstract

Objective: Previous studies have suggested the benefit of routine screening for biopsychosocial symptoms among patients with cancer. In recognition of the lack of data from low-and middle-income countries, this study sought to test and determine the effect of a mHealth program to screen biopsychological symptoms among patients with advanced breast or gynecological cancer.Methods: This was a quasi-experimental pre-post study conducted in a public hospital located in central western Brazil. Patients diagnosed with advanced breast of gynecological cancer who were about to initiate chemotherapy treatment at this institution and had access to Internet by smartphone, computer or tablet were invited to participate. Patients received training on using the app Comfort, a program developed to rate their physical and emotional symptoms during the 6-month of the proposed study. Patients were also asked to complete the EuroQOL 5D (EQ-5D-3L) every month. Mann-Whitney U test was used to determine differences among groups of patients (engaged and non-engaged). RM-ANOVA was used to determine the effect of time on mean visual analog scale (VAS) score.Results: A total of 125 patients were recruited (median age = 46.6 years old, 41.6% married). Mostly, patients possessed lower levels of education and had relatively low monthly incomes. Notably, 67.2% of patients engaged with the Comfort program, and few patients (4%) withdrew due to lack of engagement with the program or issues with internet connection. In general, patients who engaged with the program reported improvement in physical and emotional symptoms (p < 0.01), as well as in their overall quality of life (VAS; p = 0.009), compared with patients who did not engage with the program.Conclusions: This is the first mHealth program developed in Brazil for patients in a low resource setting. Our findings suggest that Comfort could be an effective resource to assist patients and health care providers track symptoms and improve patients' quality of life.

Mapping Factors That Affect the Uptake of Digital Therapeutics Within Health Systems: Scoping Review

“…Ultimately, out of 35,541 documents, we included 244 (0.69%) documents (n=234, 95.9% scientific articles; n=6, 2.5% organizational reports; n=2, 0.8% health technology assessment frameworks [although the included literature covered additional frameworks]; and n=2, 0.8% web pages) in this review ( Figure 1 ). Out of 244 documents, our final sample comprised 60 (24.6%) literature reviews [ 19 , 40 - 98 ]; 49 (20.1%) viewpoints, commentaries, and editorials [ 11 , 13 , 17 , 99 - 144 ]; 43 (17.6%) cross-sectional studies [ 83 , 145 - 186 ]; 39 (16%) qualitative research articles [ 1 , 15 , 187 - 223 ]; 13 (5.3%) case reports [ 4 , 5 , 12 , 224 - 233 ]; 11 (4.5%) longitudinal studies [ 234 - 244 ]; 9 (3.7%) mixed methods studies [ 245 - 253 ]; 5 (2%) economic evaluations [ 254 - 258 ]; 5 (2%) randomized controlled trials [ 259 - 263 ]; 4 (1.6%) policy documents [ 264 - 267 ]; 3 (1.2%) preference studies [ 268 - 270 ]; 2 (0.8%) websites [ 271 , 272 ]; and 1 (0.4%) book chapter [ 273 ]. Of the 244 included studies, 23 (9.4%) were published before 2014 [ 41 , 66 , 71 , 96 , 98 , 116 , 122 , 124 - 126 , 129 , 130 , 132 , 158 , 163 , 167 , 171 , 192 , 211 , …”

“…The mapped literature highlighted the multidimensionality and versatility of digital therapeutics by showcasing their relative advantages compared with their competitors. At the patient level, the most reported relative advantages were improvements in health outcomes and shortened disease duration through novel health care options, faster diagnoses, decrease in adverse medical events, and improved monitoring of clinical and patient-reported outcome measures [ 11 , 17 , 41 , 43 , 45 , 47 - 49 , 53 , 60 , 61 , 69 , 71 , 74 , 80 , 81 , 88 , 92 , 94 , 95 , 100 , 102 , 105 , 124 , 128 , 130 , 132 , 133 , 135 , 137 , 138 , 146 , 153 , 163 , 172 , 173 , 179 , 189 , 202 , 207 , 218 , 224 , 226 , 228 , 229 , 231 , 232 , 234 , 239 - 242 , 244 , 246 , 248 , 257 , 260 , 262 , 263 , 265 , 266 , 270 , 275 ], a...…”

“…Our search strategy yielded 49,192 1). Out of 244 documents, our final sample comprised 60 (24.6%) literature reviews [19,; 49 (20.1%) viewpoints, commentaries, and editorials [11,13,17,; 43 (17.6%) cross-sectional studies [83,; 39 (16%) qualitative research articles [1,15,; 13 (5.3%) case reports [4,5,12,[224][225][226][227][228][229][230][231][232][233]; 11 (4.5%) longitudinal studies [234][235][236][237][238][239][240][241][242][243][244]; 9 (3.7%) mixed methods studies [245][246][247][248][249][250][251][252][253]; 5 (2%) economic evaluations [254][255][256][257][258]; ...…”

Global psycho‐oncology in low middle‐income countries: Challenges and opportunities

“…have provided a step‐by‐step guide to the cultural adaptation process for cancer‐related interventions. Five studies focus on country specific issues within Kenya, 24 Ghana, 25 Uganda, 26 Indonesia 27 and Brazil 28 . All link together to highlight a common thread that psychosocial care is developing in LMICs but remains in need of improved access to resources.…”

“…Five studies focus on country specific issues within Kenya, 24 Ghana, 25 Uganda, 26 Indonesia 27 and Brazil. 28 All link together to highlight a common thread that psychosocial care is developing in LMICs but remains in need of improved access to resources. The research reported within this Special Issue accentuates that implementation strategies can be developed through multi‐disciplinary and multi‐national collaboration.…”