Mobile Health in Oncology: A Patient Survey About App-Assisted Cancer Care

Abstract

BackgroundIn the last decade, the health care sector has been enriched by numerous innovations such as apps and connected devices that assist users in weight reduction and diabetes management. However, only a few native apps in the oncological context exist, which support patients during treatment and aftercare.ObjectiveThe objective of this study was to analyze patients’ acceptance regarding app use and to investigate the functions of an oncological app that are most required, and the primary reasons for patients to refuse app-assisted cancer care.MethodsWe designed and conducted a survey with 23 questions, inquiring patients about their technical knowledge and equipment, as well as the possible advantages and disadvantages, data transfer, and general functionality of an app.ResultsA total of 375 patients participated; the participation rate was 60.7% (375/618). Gender distribution was about 3:4 (female:male) with a median age of 59 years (range 18-92 years). Whereas 69.6% (261/375) of patients used mobile devices, 16.3% (61/375) did not own one, and 9.1% (34/375) only used a personal computer (PC). About half of the patients rated their usability skills as very good and good (18.9% 71/375; 35.2% 132/375), 23.5% (88/375) described their skills as intermediate, and 14.4% (54/375) as bad. Of all patients, 182 (48.5%, 182/375) were willing to send data to their treating clinic via an app, that is, to a server (61.0% 111/182) or as email (33.5%, 61/182). About two-thirds (68.7%, 125/182) believed that additional and regularly sent data would be an ideal complement to the standard follow-up procedure. Additionally, 86.8% (158/182) wished to be contacted by a physician when entered data showed irregularities. Because of lack of skills (34.4%, 56/163), concerns about the use of data (35.0%, 57/163), lack of capable devices (25.8%, 42/163), and the wish for personal contact with the treating physician (47.2%, 77/163), a total of 163 (43.5%, 163/375) patients refused to use an app. Pearson correlation showed a significant but mild relationship between age and app use (P=.03, r=−.12), favoring younger age; male gender correlated as well (P=.04; r=−.11).ConclusionsThe results show that the introduction of mobile apps needs to follow different strategies depending on the patients’ attitude. Age and gender seem to be the strongest predictive factors. For oncology patients, our survey showed that about half of the patients were willing to send data via an app supporting their treatment. In the future, clinical data such as quality of life and treatment satisfaction recorded by mobile health (mHealth) devices could be used to evaluate and improve therapy workflow. Furthermore, apps could support classical visits, document adverse effects, and remind patients of treatment dates or drug intake.

Oncology Patient Interest in the Use of New Technologies to Manage Their Disease: Cross-Sectional Survey (Preprint)

“…Traditionally, patients have tried to physically obtain medical information from ordinary health professionals (doctors, pharmacists and nurses). However, the expansion and generalization of the use of ICTs has implied a radical change in how we obtain information about health and manage diseases [3,4,5,11,12]. While health professionals continue to be the main source of information about diseases (the first option of 75.5% (462/611) of patients is to turn to their doctor), 61.3% (375/611) (55% in the study by An LC et al [13]) also resort to the Internet for information.…”

“…The design of the questionnaire considered the model form created by ONTSI [4] and incorporated advice from a management consultancy firm specializing in process design, implementation, and improvement. With respect to the types of question, 28 comprised dichotomous (2,3,6,12,18,20,22,27), with true/false response options, or polytomous (questions 4-5, 7-10, 11, 13-17, 19, 21, 23-26) categorical variables. Ten patients completed a draft paper questionnaire to validate the fact that it was well understood.…”

Digital Follow-Up and the Perspective of Patient-Centered Care in Oncology: What’s the PROblem?

“…A survey among 108 oncologists and nurses reported that more than 80% of health care providers deemed app-based PRO reporting as useful as part of complimentary oncological surveillance [24]. Patients seemed slightly more reluctant to share their medical data with between half and two thirds of patients willing to report PROs online [25,26]. Only few clinical factors seem to influence the willingness of patients to use mobile device-based PRO reporting, including a younger age and a reduced performance status while gender, tumour stage, histology and type of treatment did not have any significant effects [26].…”

“…Beyond patient compliance, patient ability to access and use mobile technology may also pose a major challenge for mobile PRO reporting. The availability of mobile devices among cancer patients has been reported to range between 70 and 80% [25,26]; however, this patient cohort contains a considerable percentage of elderly patients that may not have access to mobile technology. In order to accommodate these patients, web-based platforms and the recruitment of family members and relatives for the collection and reporting of PROs have been used as alternative means in prospective trials [4,8].…”

Keeping the Person in Personalised Healthcare

“…The growing range of apps will also make it easier for the individual to understand at an earlier stage if a treatment is needed or not, which will also boost the chances for cost savings on unnecessary treatments - and will also provide a psychological boost for the individual, a reassurance that he or she retains some control of their own lives [28]. Education plays an important role here as well as the governance structures.…”