User-Centered Design of a Web-Based Tool to Support Management of Chemotherapy-Related Toxicities in Cancer Patients

Abstract

Background Cancer patients receiving chemotherapy have high symptom needs that can negatively impact quality of life and result in high rates of unplanned acute care visits. Remote monitoring tools may improve symptom management in this patient population. Objective This study aimed to design a prototype tool to facilitate remote management of chemotherapy-related toxicities. Methods User needs were assessed using a participatory, user-centered design methodology that included field observation, interviews, and focus groups, and then analyzed using affinity diagramming. Participants included oncology patients, caregivers, and health care providers (HCPs) including medical oncologists, oncology nurses, primary care physicians, and pharmacists in Ontario, Canada. Overarching themes informed development of a Web-based prototype, which was further refined over 2 rounds of usability testing with end users. Results Overarching themes were derived from needs assessments, which included 14 patients, 1 caregiver, and 12 HCPs. Themes common to both patients and HCPs included gaps and barriers in current systems, need for decision aids, improved communication and options in care delivery, secure access to credible and timely information, and integration into existing systems. In addition, patients identified missed opportunities, care not meeting their needs, feeling overwhelmed and anxious, and wanting to be more empowered. HCPs identified accountability for patient management as an issue. These themes informed development of a Web-based prototype ( bridges ), which included toxicity tracking, self-management advice, and HCP communication functionalities. Usability testing with 11 patients and 11 HCPs was generally positive; however, identified challenges included tool integration into existing workflows, need for standardized toxicity self-management advice, issues of privacy and consent, and patient-tailored information. Conclusions Web-based tools integrating just-in-time self-management advice and HCP support into routine care may address gaps in systems for managing chemotherapy-related toxicities. Attention to the integration of new electronic tools into self-care by patients and practice was a strong theme for both patients and HCP participants and is a key issue that needs to be addressed for wide-scale adoption.

Hematolojik Malignensi Tanılı Hastalarda Web Tabanlı Eğitimin Semptom Yönetimindeki Önemi: Literatür Derlemesi

“…Web tabanlı eğitim uygulamaları, hastaların semptom yönetiminde ve sağlık durumlarındaki değişikliklerin saptanmasında da kullanılmaktadır (17,18). Web tabanlı eğitim uygulamaları, kolay erişim, çok sayıda hastaya ulaşabilme ve yüz yüze müdahalelere kıyasla daha fazla nozokomiyal enfeksiyonlardan korunma yönüyle yarar sağlamaktadır (19)(20)(21).…”

“…Ayrıca, hemşirelerin hematolojik malignensi tanılı hastaların fiziksel, duygusal, psikososyal, bilgilendirici ve pratik gereksinimlerini karşılamak için destekleyici bakım sundukları gösterilmektedir (23,24). Hemşirelerin bu süreçte web tabanlı uygulamaları kullanmaları, hematolojik malignensi tanılı hastaların semptom yönetimlerinde, ilaç planlamalarında ve tedavi programlarının koordine edilmesinde yarar sağlamaktadır (7,10,18,21).…”

Designing Digital Health Technology to Support Patients Before and After Bariatric Surgery: Qualitative Study Exploring Patient Desires, Suggestions, and Reflections to Support Lifestyle Behavior Change

“…Cocreation and user-centered, experience-based co-design approaches are being researched and implemented in other areas of health care, with the goal of improving patient-focused care [ 40 , 41 ]. Many studies have focused on implementing digital technologies and measuring their effectiveness in various medical and surgical cohorts [ 42 , 43 ]. A recent study by Korpershoek et al [ 44 ] using user-centered design approaches supported patient self-management of chronic obstructive pulmonary disease and that by Solem et al [ 45 ] designed and developed an electronic health pain management intervention for those affected by chronic pain.…”