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Dai YM, Virtanen H, Zhu Y, Wan H. Effectiveness of mHealth intervention for trismus exercise in patients with head and neck cancer undergoing proton and heavy ion therapy: a randomized control trial. Support Care Cancer 2024; 32:470. [PMID: 38951291 DOI: 10.1007/s00520-024-08679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/21/2024] [Indexed: 07/03/2024]
Abstract
PURPOSE This study aimed to compare the effects of a mobile health intervention based on social cognitive theory with standard care on maximal mouth opening, exercise compliance, and self-efficacy in patients receiving proton and heavy ion therapy for head and neck cancer. METHODS This open-label, parallel-group, randomized, superiority trial involved a self-developed "Health Enjoy System" intervention. We assessed maximal mouth opening, exercise compliance, and self-efficacy at baseline (T0), post-treatment (T1), and at 1 month (T2) and 3 months (T3) after radiotherapy. Generalized estimating equations were used to analyze differences between the groups over time, with results reported as P values and 95% confidence intervals (CIs). RESULTS The study included 44 participants. At T3, the intervention group showed a 6 mm greater increase in maximal interincisal opening than the control group (mean difference = 6.0, 95% CI = 2.4 to 9.5, P = 0.001). There was also a significant difference in exercise compliance between the groups (mean difference = 31.7, 95% CI = 4.6 to 58.8, P = 0.022). However, no significant difference in self-efficacy was found between the groups. CONCLUSION This study demonstrated that an mHealth intervention incorporating behavior change theory could effectively enhance or maintain maximal mouth opening in patients undergoing proton and heavy ion therapy for head and neck cancer in China. This approach provides valuable support during and after treatment. TRIAL REGISTRATION ChiCTR: ChiCTR2300067550. Registered 11 Jan 2023.
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Affiliation(s)
- Yu-Mei Dai
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Heli Virtanen
- Department of Nursing Science, University of Turku, N20014, Turku, Finland
| | - Yu Zhu
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China
| | - Hongwei Wan
- Department of Nursing, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai Key Laboratory of Radiation Oncology, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, 201315, China.
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Urretavizcaya M, Álvarez K, Olariaga O, Tames MJ, Asensio A, Cajaraville G, Riestra AC. Assessing health outcomes: a systematic review of electronic patient-reported outcomes in oncology. Eur J Hosp Pharm 2024:ejhpharm-2023-004072. [PMID: 38821720 DOI: 10.1136/ejhpharm-2023-004072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
PURPOSE This study investigates the clinical impact of electronic patient-reported outcome (ePRO) monitoring apps/web interfaces, aimed at symptom-management, in cancer patients undergoing outpatient systemic antineoplastic treatment. Additionally, it explores the advantages offered by these applications, including their functionalities and healthcare team-initiated follow-up programmes. METHODS A systematic literature review was conducted using a predefined search strategy in MEDLINE. Inclusion criteria encompassed primary studies assessing symptom burden through at-home ePRO surveys in adult cancer patients receiving outpatient systemic antineoplastic treatment, whenever health outcomes were evaluated. Exclusion criteria excluded telemedicine-based interventions other than ePRO questionnaires and non-primary articles or study protocols. To evaluate the potential bias in the included studies, an exhaustive quality assessment was conducted, as an additional inclusion filter. RESULTS Among 246 identified articles, 227 were excluded for non-compliance with inclusion/exclusion criteria. Of the remaining 19 articles, only eight met the rigorous validity assessment and were included for detailed examination and data extraction, presented in attached tables. CONCLUSION This review provides compelling evidence of ePRO monitoring's positive clinical impact across diverse cancer settings, encompassing various cancer types, including early and metastatic stages. These systems are crucial in enabling timely interventions and reducing communication barriers, among other functionalities. While areas for future ePRO innovation are identified, the primary limitation lies in comparing clinical outcomes of reviewed articles, due to scale variability and study population heterogeneity. To conclude, our results reaffirm the transformative potential of ePRO apps in oncology and their pivotal role in shaping the future of cancer care.
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Affiliation(s)
| | - Karen Álvarez
- Pharmacy Department, Nuestra Senora de la Candelaria University Hospital, Santa Cruz de Tenerife, Canarias, Spain
| | - Olatz Olariaga
- Pharmacy Department, Onkologikoa, San Sebastian, País Vasco, Spain
| | - Maria Jose Tames
- Pharmacy Department, Onkologikoa, San Sebastian, País Vasco, Spain
| | - Ainhoa Asensio
- Pharmacy Department, Onkologikoa, San Sebastian, País Vasco, Spain
| | | | - Ana Cristina Riestra
- Pharmacy Department, Onkologikoa, San Sebastian, País Vasco, Spain
- Medicine Department, University of Deusto, Bilbao, País Vasco, Spain
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3
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Yunis R, Fonda SJ, Aghaee S, Kubo A, Davis SW, Liu R, Neeman E, Oakley-Girvan I. Mobile app activity engagement by cancer patients and their caregivers informs remote monitoring. Sci Rep 2024; 14:3375. [PMID: 38336943 PMCID: PMC10858186 DOI: 10.1038/s41598-024-53373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Mobile phone applications ("apps") are potentially an effective, low-burden method to collect patient-reported outcomes outside the clinical setting. Using such apps consistently and in a timely way is critical for complete and accurate data capture, but no studies of concurrent reporting by cancer patient-caregiver dyads have been published in the peer-reviewed literature. This study assessed app engagement, defined as adherence, timing, and attrition with two smartphone applications, one for adult cancer patients and one for their informal caregivers. This was a single-arm, pilot study in which adult cancer patients undergoing IV chemotherapy or immunotherapy used the DigiBioMarC app, and their caregivers used the TOGETHERCare app, for approximately one month to report weekly on the patients' symptoms and wellbeing. Using app timestamp metadata, we assessed user adherence, overall and by participant characteristics. Fifty patient-caregiver dyads completed the study. Within the one-month study period, both adult cancer patients and their informal caregivers were highly adherent, with app activity completion at 86% for cancer patients and 84% for caregivers. Caregivers completed 86% of symptom reports, while cancer patients completed 89% of symptom reports. Cancer patients and their caregivers completed most activities within 48 h of availability on the app. These results suggest that the DigiBioMarC and TOGETHERCare apps can be used to collect patient- and caregiver-reported outcomes data during intensive treatment. From our research, we conclude that metadata from mobile apps can be used to inform clinical teams about study participants' engagement and wellbeing outside the clinical setting.
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Affiliation(s)
- Reem Yunis
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA
| | | | - Sara Aghaee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sharon W Davis
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA
| | - Raymond Liu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Hematology Oncology, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Elad Neeman
- San Rafael Medical Center, Kaiser Permanente Northern California, San Rafael, CA, USA
| | - Ingrid Oakley-Girvan
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA.
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Nayak SG, George A, Sharan K, Nayak BS, Salins N. Interventions to improve quality of life in patients with head and neck cancers receiving radiation therapy: a scoping review. Support Care Cancer 2023; 32:31. [PMID: 38102525 DOI: 10.1007/s00520-023-08197-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Quality of life (QOL) is impaired in patients with head and neck cancers (HNC) due to illness and treatment-associated morbidity. Although there is evidence from the studies on interventions' role in improving QOL receiving radiation therapy, these are not systematically synthesised. In this scoping review, we searched and synthesised the evidence on interventions to improve the QOL and its impact among patients with HNCs. METHODS This scoping review was conducted using the framework proposed by Arksey and O'Malley, and the extensions suggested by Levac et al. were incorporated. Two reviewers independently searched four electronic databases using key thesaurus and free-text terms, and the data was extracted, tabulated, synthesised and reported as categories. RESULTS Seventy-nine papers reported various interventions of diverse nature such as pharmacological, physical, nutritional, complementary and alternative therapies, psychosocial, oral care related, laser and photobiomodulation therapies, rehabilitative, educational, technology-based, surgical, device-related and nurse lead interventions. Most studies reported clinically meaningful impact of interventions on QOL, although the outcome differences were often statistically insignificant. Few studies reported a combination of interventions to address the multidimensional concerns faced by patients with HNCs. None of the studies examined the impact of interventions on QOL among long-term survivors of HNCs. CONCLUSION As QOL concerns in patients with HNCs are multifaceted, more extensive studies with complex multi-component interventions and robust research designs are warranted.
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Affiliation(s)
- Shalini Ganesh Nayak
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anice George
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India.
| | - Krishna Sharan
- Radiotherapy & Oncology, KS Hegde Medical Academy, Nitte (Deemed to Be University), Mangalore, Karnataka, India
| | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Naveen Salins
- Department of Palliative Medicine and Supportive Care, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Oakley-Girvan I, Yunis R, Fonda SJ, Longmire M, Veuthey TL, Shieh J, Aghaee S, Kubo A, Davis SW, Liu R, Neeman E. Correlation Between Remote Symptom Reporting by Caregivers and Adverse Clinical Outcomes: Mixed Methods Study. J Med Internet Res 2023; 25:e49100. [PMID: 37988151 PMCID: PMC10698661 DOI: 10.2196/49100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/23/2023] [Accepted: 09/30/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Timely collection of patient-reported outcomes (PROs) decreases emergency department visits and hospitalizations and increases survival. However, little is known about the outcome predictivity of unpaid informal caregivers' reporting using similar clinical outcome assessments. OBJECTIVE The aim of this study is to assess whether caregivers and adults with cancer adhered to a planned schedule for electronically collecting patient-reported outcomes (PROs) and if PROs were associated with future clinical events. METHODS We developed 2 iPhone apps to collect PROs, one for patients with cancer and another for caregivers. We enrolled 52 patient-caregiver dyads from Kaiser Permanente Northern California in a nonrandomized study. Participants used the apps independently for 4 weeks. Specific clinical events were obtained from the patients' electronic health records up to 6 months following the study. We used logistic and quasi-Poisson regression analyses to test associations between PROs and clinical events. RESULTS Participants completed 97% (251/260) of the planned Patient-Reported Outcomes Common Terminology Criteria for Adverse Events (PRO-CTCAE) surveys and 98% (254/260) of the Patient-Reported Outcomes Measurement Information System (PROMIS) surveys. PRO-CTCAE surveys completed by caregivers were associated with patients' hospitalizations or emergency department visits, grade 3-4 treatment-related adverse events, dose reductions (P<.05), and hospice referrals (P=.03). PROMIS surveys completed by caregivers were associated with hospice referrals (P=.02). PRO-CTCAE surveys completed by patients were not associated with any clinical events, but their baseline PROMIS surveys were associated with mortality (P=.03), while their antecedent or final PROMIS surveys were associated with all clinical events examined except for total days of treatment breaks. CONCLUSIONS In this study, caregivers and patients completed PROs using smartphone apps as requested. The association of caregiver PRO-CTCAE surveys with patient clinical events suggests that this is a feasible approach to reducing patient burden in clinical trial data collection and may help provide early information about increasing symptom severity.
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Affiliation(s)
| | - Reem Yunis
- Medable Inc, Palo Alto, CA, United States
| | | | | | - Tess L Veuthey
- Kaiser Permanente Northern California, San Francisco, CA, United States
| | - Jennifer Shieh
- Kaiser Permanente Northern California, San Francisco, CA, United States
| | - Sara Aghaee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | | | - Raymond Liu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
- Department of Hematology Oncology, Kaiser Permanente Northern California, San Francisco, CA, United States
| | - Elad Neeman
- Kaiser Permanente Northern California, San Rafael, CA, United States
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van de Weerd C, Ebbers T, Smilde DEM, van Tol‐Geerdink JJ, Takes RP, van den Broek GB, Hermens RPMG, Kool RB. Evaluation of a remote monitoring app in head and neck cancer follow-up care. Cancer Med 2023; 12:15552-15566. [PMID: 37293944 PMCID: PMC10417106 DOI: 10.1002/cam4.6202] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 05/01/2023] [Accepted: 05/23/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND A remote monitoring app was developed for head and neck cancer (HNC) follow-up during the SARS-CoV-2 pandemic. This mixed-methods study provides insight in the usability and patients' experiences with the app to develop recommendations for future use. METHODS Patients were invited to participate if they were treated for HNC, used the app at least once and were in clinical follow-up. A subset was selected for semi-structured interviews through purposive sampling considering gender and age. This study was conducted between September 2021-May 2022 at a Dutch university medical center. RESULTS 135 of the 216 invited patients completed the questionnaire, resulting in a total mHealth usability score of 4.72 (± 1.13) out of 7. Thirteen semi-structured interviews revealed 12 barriers and 11 facilitators. Most of them occurred at the level of the app itself. For example, patients received no feedback when all their answers were normal. The app made patients feel more responsible over their follow-up, but could not fulfill the need for personal contact with the attending physician. Patients felt that the app could replace some of the outpatient follow-up visits. CONCLUSIONS Our app is user-friendly, makes patients feel more in control and remote monitoring can reduce the frequency of outpatient follow-up visits. The barriers that emerged must be resolved before the app can be used in regular HNC follow-up. Future studies should investigate the appropriate ratio of remote monitoring to outpatient follow-up visits and the cost-effectiveness of remote monitoring in oncology care on a larger scale.
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Affiliation(s)
- Cecile van de Weerd
- Department of Otorhinolaryngology and Head and Neck SurgeryRadboud University Medical CenterNijmegenthe Netherlands
| | - Tom Ebbers
- Department of Otorhinolaryngology and Head and Neck SurgeryRadboud University Medical CenterNijmegenthe Netherlands
| | - Donna E. M. Smilde
- Department of Otorhinolaryngology and Head and Neck SurgeryRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Robert P. Takes
- Department of Otorhinolaryngology and Head and Neck SurgeryRadboud University Medical CenterNijmegenthe Netherlands
| | - Guido B. van den Broek
- Department of Otorhinolaryngology and Head and Neck SurgeryRadboud University Medical CenterNijmegenthe Netherlands
| | | | - Rudolf B. Kool
- Department of IQ HealthcareRadboud University Medical CenterNijmegenthe Netherlands
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Ogunsanya ME, Sifat M, Bamidele OO, Ezenwankwo EF, Clifton S, Ton C, Knight JM, Odedina FT, Greer JA, Dwyer K, Kendzor DE. Mobile health (mHealth) interventions in prostate cancer survivorship: a scoping review. J Cancer Surviv 2023; 17:557-568. [PMID: 36627464 DOI: 10.1007/s11764-022-01328-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/27/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE This scoping review explores the application of mHealth technology in prostate cancer (CaP) management along the survivorship continuum. METHODS The scoping review was conducted using the five-step framework developed by Arksey and O'Malley. Using predefined criteria, we screened citations from Embase, EBSCOHost, Cochrane Library, PubMed, ProQuest, SCOPUS, and Web of Science for primary studies published before December 2021. We selected studies that explored the application of mHealth technology in CaP management and survivorship. Evidence from 14 eligible studies was summarized using narrative synthesis. RESULTS Fourteen studies published between 2015 and 2021 were included. Ten mHealth apps were identified with only one still in use. Most apps were explored for their supportive care roles during radiotherapy (n = 9) and androgen deprivation therapy (ADT) (n = 1) treatment, mainly to assess outcomes (n = 1) and manage patient-reported symptoms (n = 5). One study deployed mHealth to facilitate recovery after surgery. Very few studies (n = 3) applied mHealth for lifestyle management (i.e., physical activity). Barriers to app usage included connectivity issues, end-user familiarity with the app, login hurdles, and time constraints. Facilitators of app usage included apps being downloaded for participants, devices provided for participants, and the ability to connect with providers through the platform. CONCLUSIONS AND IMPLICATIONS FOR CANCER SURVIVORS The improving survival rates from CaP suggest that men are now living longer with unfavorable treatment side effects such as reduced sexual functioning, pain, and fatigue. Hence, mHealth represents new hope in men's illness trajectory. However, current application in patients' care pathways remains poor, particularly in the active phase of CaP management. Efforts must be accelerated to explore individual and healthcare-level drivers of mHealth use. The feasibility and descriptive nature of current studies point to a lack of attention to actual implementation and scale-up issues in research considering mHealth application in CaP, hence accounting partly for the gap in research/practice.
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Affiliation(s)
- Motolani E Ogunsanya
- College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA.
| | - Munjireen Sifat
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
| | - Olufikayo O Bamidele
- Hull York Medical School, University of Hull, Cottingham Road, Hull, HU6 7RX, UK
| | | | - Shari Clifton
- Health Sciences Library & Information Management, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Chelsea Ton
- College of Pharmacy, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Jennifer M Knight
- Departments of Psychiatry, Medicine, and Microbiology & Immunology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Folakemi T Odedina
- Center for Health Equity & Community Engagement Research, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Joseph A Greer
- Center for Psychiatric Oncology & Behavioral Sciences, Massachusetts General Hospital, Boston, MA, USA
| | - Kathleen Dwyer
- College of Nursing, University of Oklahoma, Oklahoma City, OK, USA
| | - Darla E Kendzor
- TSET Health Promotion Research Center, Stephenson Cancer Center, Oklahoma City, OK, USA
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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Janssen S, El Shafie RA, Ruder AM, Buergy D, Scafa D, Giordano FA, Nicolay NH, Vogel MME, Combs SE, Fahlbusch FB, Rades D, Käsmann L. Mobile applications in radiation oncology-current choices and future potentials. Strahlenther Onkol 2023; 199:337-349. [PMID: 36810957 PMCID: PMC9943039 DOI: 10.1007/s00066-023-02048-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 01/15/2023] [Indexed: 02/24/2023]
Abstract
PURPOSE To review existing scientific literature on mobile applications (apps) in the field of radiation oncology and to evaluate characteristics of commercially available apps across different platforms. METHODS A systematic review of the literature for publications presenting apps in the field of radiation oncology was carried out using the PubMed database, Cochrane library, Google Scholar, and annual meetings of major radiation oncology societies. Additionally, the two major marketplaces for apps, App Store and Play Store, were searched for available radiation oncology apps for patients and health care professionals (HCP). RESULTS A total of 38 original publications which met the inclusion criteria were identified. Within those publications, 32 apps were developed for patients and 6 for HCP. The vast majority of patient apps focused on documenting electronic patient-reported outcomes (ePROs). In the two major marketplaces, 26 apps were found, mainly supporting HCP with dose calculations. CONCLUSION Apps used in (and for) scientific research in radiation oncology are rarely available for patients and HCP in common marketplaces.
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Affiliation(s)
- Stefan Janssen
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany.
- Private Practice of Radiation Oncology, Hannover, Germany.
| | - Rami A El Shafie
- Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Göttingen, Germany
| | - Arne M Ruder
- Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Daniel Buergy
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Davide Scafa
- Department of Radiation Oncology, University Medical Center Bonn (UKB), Bonn, Germany
| | - Frank A Giordano
- Department of Radiation Oncology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, University of Leipzig Medical Center, Leipzig, Germany
| | - Marco M E Vogel
- Department of Radiation Oncology, University Hospital Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
- Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, University Hospital Klinikum rechts der Isar, Technical University of Munich (TUM), Ismaninger Str. 22, 81675, Munich, Germany
- Institute for Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München, Neuherberg, Germany
| | - Fabian B Fahlbusch
- Department of Pediatrics and Adolescent Medicine, Neonatology and Pediatric Intensive Care, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Germany
| | - Dirk Rades
- Department of Radiation Oncology, University of Lübeck, Lübeck, Germany
| | - Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany
- Partner Site Munich, German Cancer Consortium (DKTK), Munich, Germany
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Feasibility and efficacy of telerehabilitation in the management of patients with head and neck cancer during and after oncological treatment: A systematic review. Eur J Oncol Nurs 2023; 63:102279. [PMID: 36889246 DOI: 10.1016/j.ejon.2023.102279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/25/2023] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
PURPOSE The aim in this review was to evaluate recent advances in telerehabilitation for the management of patients with head and neck cancer (HNC) during and after their oncological treatment. METHODS A systematic review was carried out in three databases (Medline, Web of Science and Scopus) in July 2022. The methodological quality of randomised clinical trials and quasi-experimental ones was assessed using the Cochrane tool (RoB 2.0) and the Critical Appraisal Checklists of the Joanna Briggs Institute, respectively. RESULTS 14 out of 819 studies met the inclusion criteria: 6 studies were randomised clinical trials, 1 was a single-arm study with historical controls and 7 were feasibility studies. Most studies reported high participant satisfaction and efficacy of telerehabilitation used, in addition, no adverse effects were reported. None of the randomised clinical trials achieved a low overall risk of bias, whereas the methodological risk of bias of the quasi-experimental studies was low. CONCLUSIONS This systematic review demonstrates that telerehabilitation offers feasible and effective interventions for the patients with HNC follow-up, during and after their oncological treatment. It was observed that telerehabilitation interventions should be personalised according to the patient's characteristics and the stage of the disease. Further research on telerehabilitation to support caregivers as well as to carry out studies with a long-term follow-up of these patients are imperative.
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Iizuka T, Minamoto T, Nasada T, Sakai T, Ishida T, Wakayama T, Kotoura N, Fujiwara M, Suzuki H, Maeda T, Nishiwaki K. [Construction of a System That Links Treatment RIS Terminals and Smartphones to Facilitate Radiation Therapy Operations]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2023; 79:46-51. [PMID: 36418062 DOI: 10.6009/jjrt.2023-1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Confirmation of patient information is required to ensure the safety of radiation therapy. The purpose of this study was to construct a system that facilitates radiation therapy operations by linking a radiation therapy information system to a smartphone. By linking a smartphone to a radiation therapy operation support system, without using a PC terminal, we were able to input information about the patient's position and fixation into images taken with a smartphone. In addition, patient information could be directly linked into the radiation therapy information system. In addition, patient information could be verified in the irradiation room by synchronizing the smartphone with the radiation therapy support system. The questionnaire was highly evaluated in terms of radio reception, usability, visibility and barcode reading. In this study, by linking a smartphone to a radiotherapy information system, it was possible to construct a system that facilitates radiotherapy operations by checking and registering patient information at hand.
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Affiliation(s)
- Takafumi Iizuka
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Takahiro Minamoto
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Toshiya Nasada
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Toshiyuki Sakai
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Toshihisa Ishida
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Tsukasa Wakayama
- Department of Radiological Technology, Hyogo Medical University Hospital
| | - Noriko Kotoura
- Department of Radiological Technology, Hyogo Medical University Hospital
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Eysenbach G, Goldsack JC, Cordovano G, Downing A, Fields KK, Geoghegan C, Grewal U, Nieva J, Patel N, Rollison DE, Sah A, Said M, Van De Keere I, Way A, Wolff-Hughes DL, Wood WA, Robinson EJ. Advancing Digital Health Innovation in Oncology: Priorities for High-Value Digital Transformation in Cancer Care. J Med Internet Res 2023; 25:e43404. [PMID: 36598811 PMCID: PMC9850283 DOI: 10.2196/43404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/17/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Although health care delivery is becoming increasingly digitized, driven by the pursuit of improved access, equity, efficiency, and effectiveness, progress does not appear to be equally distributed across therapeutic areas. Oncology is renowned for leading innovation in research and in care; digital pathology, digital radiology, real-world data, next-generation sequencing, patient-reported outcomes, and precision approaches driven by complex data and biomarkers are hallmarks of the field. However, remote patient monitoring, decentralized approaches to care and research, "hospital at home," and machine learning techniques have yet to be broadly deployed to improve cancer care. In response, the Digital Medicine Society and Moffitt Cancer Center convened a multistakeholder roundtable discussion to bring together leading experts in cancer care and digital innovation. This viewpoint highlights the findings from these discussions, in which experts agreed that digital innovation is lagging in oncology relative to other therapeutic areas. It reports that this lag is most likely attributed to poor articulation of the challenges in cancer care and research best suited to digital solutions, lack of incentives and support, and missing standardized infrastructure to implement digital innovations. It concludes with suggestions for actions needed to bring the promise of digitization to cancer care to improve lives.
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Affiliation(s)
| | | | | | | | - Karen K Fields
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
| | | | | | - Jorge Nieva
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, United States
| | - Nikunj Patel
- AstraZeneca PLC, Gaithersburg, MD, United States
| | - Dana E Rollison
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
| | - Archana Sah
- AS Pharma Advisors, Inc, San Francisco, CA, United States
| | - Maya Said
- Outcomes4Me Inc, Boston, MA, United States
| | | | - Amanda Way
- Jazz Venture Partners, San Francisco, CA, United States
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Populations Sciences, National Cancer Institute, Bethesda, MD, United States
| | - William A Wood
- Lineberger Comprehensive Cancer Center, University of North Carolina Chapel Hill, Chapel Hill, NC, United States
| | - Edmondo J Robinson
- Center for Digital Health, Moffitt Cancer Center, Tampa, FL, United States
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12
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Oakley-Girvan I, Yunis R, Fonda SJ, Neeman E, Liu R, Aghaee S, Ramsey ME, Kubo A, Davis SW. Usability evaluation of mobile phone technologies for capturing cancer patient-reported outcomes and physical functions. Digit Health 2023; 9:20552076231186515. [PMID: 37456127 PMCID: PMC10338665 DOI: 10.1177/20552076231186515] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Background By eliminating the requirement for participants to make frequent visits to research sites, mobile phone applications ("apps") may help to decentralize clinical trials. Apps may also be an effective mechanism for capturing patient-reported outcomes and other endpoints, helping to optimize patient care during and outside of clinical trials. Objectives We report on the usability of Digital BioMarkers for Clinical Impact (DigiBioMarC™ (DBM)), a novel smartphone-based app used by cancer patients in conjunction with a wearable device (Apple Watch®). DBM is designed to collect patient-reported outcomes and record physical functions. Methods In a fully decentralized "bring-your-own-device" smartphone study, we enrolled 54 cancer patient and caregiver dyads from Kaiser Permanente Northern California (KPNC) from October 2020 through March 2021. Patients used the app for at least 28 days, completed weekly questionnaires about their symptoms, physical functions, and mood, and performed timed physical tasks. Usability was determined through a subset of the Mobile App Rating Scale (MARS), the full System Usability Scale (SUS), the Net Promoter Score (NPS), and semi-structured interviews. Results We obtained usability survey data from 50 of 54 patients. Median responses to the selected MARS questions and the mean SUS scores indicated above average usability. The NPS from the semi-structured interviews at the end of the study was 24, indicating a favorable score. Conclusions Cancer patients reported above average usability for the DBM app. Qualitative analyses indicated that the app was easy to use and helpful. Future work will emphasize implementing further patient recommendations and evaluating the app's clinical efficacy in multiple settings.
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Affiliation(s)
- Ingrid Oakley-Girvan
- Strategy and Science Departments, Medable Inc., Palo Alto, CA, USA
- The Data and Technology Proving Ground, The Public Health Institute, Oakland, CA, USA
| | - Reem Yunis
- Strategy and Science Departments, Medable Inc., Palo Alto, CA, USA
| | | | - Elad Neeman
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Raymond Liu
- San Francisco Medical Center, Kaiser Permanente Northern California, San Francisco, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sara Aghaee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Maya E Ramsey
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sharon W Davis
- Strategy and Science Departments, Medable Inc., Palo Alto, CA, USA
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13
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The Normal, the Radiosensitive, and the Ataxic in the Era of Precision Radiotherapy: A Narrative Review. Cancers (Basel) 2022; 14:cancers14246252. [PMID: 36551737 PMCID: PMC9776433 DOI: 10.3390/cancers14246252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
(1) Background: radiotherapy is a cornerstone of cancer treatment. When delivering a tumoricidal dose, the risk of severe late toxicities is usually kept below 5% using dose-volume constraints. However, individual radiation sensitivity (iRS) is responsible (with other technical factors) for unexpected toxicities after exposure to a dose that induces no toxicity in the general population. Diagnosing iRS before radiotherapy could avoid unnecessary toxicities in patients with a grossly normal phenotype. Thus, we reviewed iRS diagnostic data and their impact on decision-making processes and the RT workflow; (2) Methods: following a description of radiation toxicities, we conducted a critical review of the current state of the knowledge on individual determinants of cellular/tissue radiation; (3) Results: tremendous advances in technology now allow minimally-invasive genomic, epigenetic and functional testing and a better understanding of iRS. Ongoing large translational studies implement various tests and enriched NTCP models designed to improve the prediction of toxicities. iRS testing could better support informed radiotherapy decisions for individuals with a normal phenotype who experience unusual toxicities. Ethics of medical decisions with an accurate prediction of personalized radiotherapy's risk/benefits and its health economics impact are at stake; (4) Conclusions: iRS testing represents a critical unmet need to design personalized radiotherapy protocols relying on extended NTCP models integrating iRS.
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14
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Efficacy of an Integrated Mobile Application System for Patients with Radiation Therapy: A Pilot Study. Healthcare (Basel) 2022; 10:healthcare10091696. [PMID: 36141313 PMCID: PMC9498518 DOI: 10.3390/healthcare10091696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/25/2022] [Accepted: 09/04/2022] [Indexed: 11/21/2022] Open
Abstract
The use of IT applications for patients undergoing radiotherapy is limited. This study aimed to develop an integrated system for communication between patients and radiation oncologists using IT technology and report the first test results for the system “Assisted Radiation Oncology Mobile Application” (AROMA). This system consisted of a manager program, a server running on a PC, and a mobile application on a smartphone. A prospective survey was conducted to evaluate the usefulness of this system from October 2020 to January 2021. The survey consisted of a specific questionnaire on basic information and application use by the patients. The management program was designed such that the user (doctor) edits the treatment schedule, member (patient and doctor) information, self-management, disease information, and side effect questionnaire. The mobile application for patients consisted of the current schedule, treatment schedule calendar, side effect questionnaire, side effect management method, and disease information entered by the doctor. A total of 41 patients were enrolled in this study. The mean adverse event response time was 4.4 days. In the survey, the mobile application received positive views (8.6/10 points). Most responses related to the side effect reporting function (94%) and communication using the application (91%) were positive. Satisfaction with the application design and each menu item was high, with an average of ≥8 and ≥8.5 points in most cases, respectively. The survey showed good satisfaction with the design, operability, and reporting system. Therefore, the system can facilitate communication between patients and radiation oncologists in the future.
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15
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da Silva HEC, Santos GNM, Ferreira Leite A, Mesquita CRM, de Souza Figueiredo PT, Miron Stefani C, de Santos Melo N. The feasibility of telehealth in the monitoring of head and neck cancer patients: a systematic review on remote technology, user adherence, user satisfaction, and quality of life. Support Care Cancer 2022; 30:8391-8404. [PMID: 35524146 DOI: 10.1007/s00520-022-07109-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES This systematic review aimed to analyze the use of telehealth in monitoring patients with head and neck cancer regarding the application used, user adherence to technology, user satisfaction, and user quality of life. MATERIALS AND METHODS A search strategy was developed using the PICO acronym and the terms "Head and Neck Cancer," "Telehealth," "Mobile Application," and "Supportive Care." A broad literature search was performed on PubMed, Cochrane Library, Scopus, Web of Science, Lilacs, and Embase databases and on grey literature through Open Grey, Google Scholar, and Jstor, for studies comparing the monitoring of head and neck cancer patients with telehealth apps to the monitoring performed in a traditional way at health units. No study design, publication status, publication time, or language restrictions were applied. Pairs of reviewers worked independently for study selection and risk of bias assessment. The protocol was registered in PROSPERO and the PRISMA checklist used for reporting the review. RESULTS We found 393 references in the databases, 325 after duplicate removal; 19 met the criteria for full-text reading; 08 studies were included for qualitative synthesis. Although there was heterogeneity regarding the technology used, the studies included showed that remote monitoring and/or self-management of symptoms through mobile applications was feasible for most patients, with satisfactory degrees of acceptability, satisfaction, usability, and adherence. The health-related quality of life improved with the use of remote technologies for telehealth, associated with low to moderate self-efficacy, higher personal control, and higher knowledge of health with clinically acceptable levels of accuracy compared to traditional clinical evaluation. Even when the data presented were not statistically significant, patients reported improvement in health-related quality of life after the intervention. CONCLUSIONS Telehealth monitoring through the use of remote technologies presents itself as an alternative way of educating and supporting patients during the treatment of Head and Neck Cancer (HNC). There is the need for a more user-friendly interface, adequate user experience assessment, and the concrete applicability of telehealth technologies for monitoring patients with HNC in order to legitimize the cost-effectiveness of developing long-term multicenter longitudinal studies term.
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Affiliation(s)
- Helbert Eustáquio Cardoso da Silva
- Dentistry Department, Faculty of Health Science, Brasilia University, Brasília, Brazil. .,UnB - Campus Universitário Darcy Ribeiro, Brasília, DF, 70910-900, Brazil.
| | | | - André Ferreira Leite
- Dentistry Department, Faculty of Health Science, Brasilia University, Brasília, Brazil
| | | | | | | | - Nilce de Santos Melo
- Dentistry Department, Faculty of Health Science, Brasilia University, Brasília, Brazil
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16
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Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. Objective The aim of this review was to systematically investigate the literature to understand the factors affecting patients’ adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. Results The technical factors affecting patients’ adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team’s role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients’ insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions This review builds on the growing body of research that investigates patients’ adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools’ fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
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Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States.,NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
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17
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Yin S, Cai X, Wang Z, Zhang Y, Luo S, Ma J. Impact of gamification elements on user satisfaction in health and fitness applications: A comprehensive approach based on the Kano model. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107106] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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18
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Lin T, Wang Y, Huang C. Effects of a mobile oral care app on oral mucositis, pain, nutritional status, and quality of life in patients with head and neck cancer: A quasi‐experimental study. Int J Nurs Pract 2022; 28:e13042. [DOI: 10.1111/ijn.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/03/2021] [Accepted: 02/02/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Tzu‐Hsuan Lin
- Department of Nursing Hsinchu Mackay Memorial Hospital Hsinchu Taiwan
| | - Yu‐Ming Wang
- Department of Psychology Chung Shan Medical University, Clinical Psychological Room, Chung Shan Medical University Hospital Taichung Taiwan
| | - Cheng‐Yi Huang
- Department of Nursing Chung Shan Medical University Taichung Taiwan
- Department of Nursing Chung Shan Medical University Hospital Taichung Taiwan
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19
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Wilczynski O, Boisbouvier A, Radoszycki L, Cotté FE, Gaudin AF, Lemasson H. Integrating Quality of Life in the Care Pathway of Cancer Patients Undergoing Immunotherapy Treatment: Descriptive, Cross-sectional Survey of an Online Patient Community's Experiences and Expectations. J Med Internet Res 2022; 24:e25792. [PMID: 35014969 PMCID: PMC8790682 DOI: 10.2196/25792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/12/2021] [Accepted: 10/26/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND New cancer treatments, such as immune checkpoint inhibitors (ICIs), can improve survival and health-related quality of life (HRQoL) in patients with cancer. Although long-term monitoring of HRQoL has been shown to improve survival, integration of HRQoL into everyday practice remains poorly documented. OBJECTIVE This study describes experiences and expectations of patients treated with ICIs regarding a discussion of HRQoL with health care professionals (HCPs) in cancer management. METHODS This cross-sectional study was conducted in an online patient community (Carenity) in France. Patients treated with ICIs for cancer, included between September 2018 and January 2019, completed a questionnaire to assess the involvement of HCP in a discussion of HRQoL and when and what was discussed. RESULTS Of 82 patients included (mean age: 56.9 years, 95% CI 54.2-59.6; 46 [56%] male; 34 [41%] with lung cancer), 62 (76%) reported discussing HRQoL at least once with HCPs, mainly general practitioners (54/82, 66%), oncologists (53/82, 65%), and hospital nurses (50/82, 61%). Around half (45/82, 55%) of the patients were satisfied with these discussions. Discussions with the oncologist were at the patient's initiative (34/53, 64%). Discussions occurred primarily during follow-up visits (40/62, 65%), when adverse events occurred (30/62, 48%), and at treatment initiation (27/62, 32%). The most discussed dimensions were symptoms (48/62, 77%) and physical well-being (43/62, 69%). With respect to expectations, 54/82 (66%) patients considered oncologists as the most important HCPs for discussing HRQoL. These discussions were desirable throughout the care pathway, particularly at diagnosis (63/82, 77%) and when treatment was initiated (75/82, 92%) or changed (68/82, 83%). All HRQoL dimensions were considered important to discuss. CONCLUSIONS With only around half of the patients satisfied with HRQoL discussions, impactful HRQoL integration in clinical practice is critical. According to patients, this integration should involve mainly oncologists and general practitioners, should happen at every step of the care pathway, and should be extended to dimensions that are currently rarely addressed.
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20
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The effect of navigation programme on the management of symptoms related to head and neck radiotherapy. Transpl Immunol 2021; 69:101488. [PMID: 34687909 DOI: 10.1016/j.trim.2021.101488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Accepted: 10/18/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND This study aims to determine the effect of navigation programme in the management of symptoms related to head and neck cancer (HNC) radiotherapy. METHODS This randomized, controlled and experimental study was conducted between November 2018 and March 2020 with the participation of 88 patients with HNC receiving radiotherapy. Referring to the pre-prepared randomization checklist, 41 people were randomized to the experimental group and 47 to the control group. While the standard treatment approaches of the hospital were applied to all patients, the patients in the experimental group were applied an additional nursing navigation program. At the beginning of the navigation program, the patients were given a 30-minute visual training on the first day of radiotherapy and a handbook related to the expected adverse effects. Throughout subsequent seven weeks, the patient continued to be followed up via phone reminders, providing daily counseling and a weekly follow-up. Patient identification form, CTCAE v5.0 toxicity criteria and EORTC QLQ-30, H&N35 assessment questionnaires were used in the study. The first result was the difference observed in quality of life scores at the beginning, middle and end of radiotherapy. RESULTS Data obtained from the study revealed that the quality of life scores (p < 0.05) improved while the navigation program reduced the severity of symptoms such as mucositis, dysphagia, oral pain and weight loss (p < 0.05). CONCLUSION It was concluded that navigation programme is an effective approach for patients receiving head and neck radiotherapy. TRIAL REGISTRATION NCT04857749.
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21
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Teni FS, Gerdtham UG, Leidl R, Henriksson M, Åström M, Sun S, Burström K. Inequality and heterogeneity in health-related quality of life: findings based on a large sample of cross-sectional EQ-5D-5L data from the Swedish general population. Qual Life Res 2021; 31:697-712. [PMID: 34628587 PMCID: PMC8921093 DOI: 10.1007/s11136-021-02982-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 11/24/2022]
Abstract
Purpose This study aimed to investigate inequality and heterogeneity in health-related quality of life (HRQoL) and to provide EQ-5D-5L population reference data for Sweden. Methods Based on a large Swedish population-based survey, 25,867 respondents aged 30‒104 years, HRQoL is described by sex, age, education, income, economic activity, health-related behaviours, self-reported diseases and conditions. Results are presented by EQ-5D-5L dimensions, respondents rating of their overall health on the EQ visual analogue scale (EQ VAS), VAS index value and TTO (time trade-off) index value allowing for calculation of quality-adjusted life years (QALYs). Ordinary Least Squares and multivariable logistic regression analyses were used to study inequalities in observed EQ VAS score between socioeconomic groups and the likelihood to report problems on the dimensions, respectively, adjusted for confounders. Results In total, 896 different health states were reported; 24.1% did not report any problems. Most problems were reported with pain/discomfort. Women reported worse HRQoL than men, and health deteriorated with age. The strongest association between diseases and conditions and EQ VAS score was seen for depression and mental health problems. There was a socioeconomic gradient in HRQoL; adjusting for health-related behaviours, diseases and conditions slightly reduced the differences between educational groups and income groups, but socioeconomic inequalities largely remained. Conclusion EQ-5D-5L population reference (norms) data are now available for Sweden, including socioeconomic differentials. Results may be used for comparisons with disease-specific populations and in health economic evaluations. The observed socioeconomic inequality in HRQoL should be of great importance for policy makers concerned with equity aspects. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02982-3.
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Affiliation(s)
- Fitsum Sebsibe Teni
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden
| | - Ulf-G Gerdtham
- Department of Economics, Lund University, Lund, Sweden.,Health Economics Unit, Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden
| | - Reiner Leidl
- Institute for Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.,Munich Center of Health Sciences, Ludwig-Maximilians University, Munich, Germany
| | - Martin Henriksson
- Center for Medical Technology Assessment, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mimmi Åström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.,Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Sun Sun
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Kristina Burström
- Health Outcomes and Economic Evaluation Research Group, Stockholm Centre for Healthcare Ethics, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18a, 171 77, Stockholm, Sweden. .,Equity and Health Policy Research Group, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
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22
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Mobile health applications for the care of patients with breast cancer: A scoping review. Int J Nurs Sci 2021; 8:470-476. [PMID: 34631997 PMCID: PMC8488816 DOI: 10.1016/j.ijnss.2021.07.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/29/2021] [Accepted: 07/23/2021] [Indexed: 12/09/2022] Open
Abstract
Objectives In recent years, the use of mobile health applications (mHealth apps) to deliver care for patients with breast cancer has increased exponentially. This study aimed to summarize the available evidence on developing mHealth apps to care for patients with breast cancer and identify the need for systematic efforts. Methods A scoping review was performed according to Arksey and O'Malley's framework, aiming to identify eligible research studies in PubMed, CINAHL, and Web of Science between January 2010 and December 2020. All identified studies were screened, extracted, and analyzed independently by two reviewers. Results A total of 676 studies were retrieved, and eight eligible studies were finally included. Four themes emerged: the involvement of patients and health professionals in the phases of design and development, patients' preferences, the characteristics of patients, and the motivators to use mHealth apps. The results indicated promising prospects for using mHealth apps to care for patients with breast cancer and identified the need for systematic efforts to develop and validate relevant apps. Conclusions The attributes of patient characteristics, needs, and patient-reported outcomes data are vital components for developing mHealth apps for patients with breast cancer. Additionally, collaborative efforts, including patients, nurses, and other significant health professionals, should develop mHealth apps for breast cancer care. Additional research focusing on the design and development of mHealth apps for patients with breast cancer is warranted.
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Parimbelli E, Wilk S, Cornet R, Sniatala P, Sniatala K, Glaser SLC, Fraterman I, Boekhout AH, Ottaviano M, Peleg M. A review of AI and Data Science support for cancer management. Artif Intell Med 2021; 117:102111. [PMID: 34127240 DOI: 10.1016/j.artmed.2021.102111] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 12/23/2020] [Accepted: 05/11/2021] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Thanks to improvement of care, cancer has become a chronic condition. But due to the toxicity of treatment, the importance of supporting the quality of life (QoL) of cancer patients increases. Monitoring and managing QoL relies on data collected by the patient in his/her home environment, its integration, and its analysis, which supports personalization of cancer management recommendations. We review the state-of-the-art of computerized systems that employ AI and Data Science methods to monitor the health status and provide support to cancer patients managed at home. OBJECTIVE Our main objective is to analyze the literature to identify open research challenges that a novel decision support system for cancer patients and clinicians will need to address, point to potential solutions, and provide a list of established best-practices to adopt. METHODS We designed a review study, in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzing studies retrieved from PubMed related to monitoring cancer patients in their home environments via sensors and self-reporting: what data is collected, what are the techniques used to collect data, semantically integrate it, infer the patient's state from it and deliver coaching/behavior change interventions. RESULTS Starting from an initial corpus of 819 unique articles, a total of 180 papers were considered in the full-text analysis and 109 were finally included in the review. Our findings are organized and presented in four main sub-topics consisting of data collection, data integration, predictive modeling and patient coaching. CONCLUSION Development of modern decision support systems for cancer needs to utilize best practices like the use of validated electronic questionnaires for quality-of-life assessment, adoption of appropriate information modeling standards supplemented by terminologies/ontologies, adherence to FAIR data principles, external validation, stratification of patients in subgroups for better predictive modeling, and adoption of formal behavior change theories. Open research challenges include supporting emotional and social dimensions of well-being, including PROs in predictive modeling, and providing better customization of behavioral interventions for the specific population of cancer patients.
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Affiliation(s)
| | - S Wilk
- Poznan University of Technology, Poland
| | - R Cornet
- Amsterdam University Medical Centre, the Netherlands
| | | | | | - S L C Glaser
- Amsterdam University Medical Centre, the Netherlands
| | - I Fraterman
- Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - A H Boekhout
- Netherlands Cancer Institute, Amsterdam, the Netherlands
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Teckie S, Solomon J, Kadapa K, Sanchez K, Orner D, Kraus D, Kamdar DP, Pereira L, Frank D, Diefenbach M. A Mobile Patient-Facing App for Tracking Patient-Reported Outcomes in Head and Neck Cancer Survivors: Single-Arm Feasibility Study. JMIR Form Res 2021; 5:e24667. [PMID: 33739291 PMCID: PMC8075070 DOI: 10.2196/24667] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/02/2020] [Accepted: 01/17/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) frequently experience disease-related symptoms and treatment adverse effects that impact their overall quality of life. Cancer-specific mobile health apps for patient-related outcomes allow patients to communicate with their clinicians and proactively track their symptoms, which have been shown to improve clinical management and disease outcomes. OBJECTIVE The purpose of this study was to evaluate the feasibility of LogPAL, a novel iPhone-based mobile health app designed to help HNC survivors track and manage their posttreatment symptoms. METHODS Patients who completed curative treatment for HNC in the preceding 24 months were recruited from 2 clinical sites within a single institution. Upon enrollment, participants completed a brief sociodemographic survey, downloaded the app onto their iPhone devices, and were asked to complete a series of biweekly questionnaires (based on the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events) via the app for an 8-week study period. The primary feasibility endpoints included retention (retaining >80% of the enrolled participants for the duration of the study period), adherence (>50% of the participants completing 100% of the questionnaires over the study period), and usability (a mean system usability scale [SUS] score >68). Additional postintervention questions were collected to assess perceived usefulness, acceptance, and overall satisfaction. RESULTS Between January and October 2019, 38 participants were enrolled in the study. Three participants dropped out, and 3 were classified as nonusers. The remaining 32 (87%) were eligible for analysis. Their mean age was 57.8 (SD 12.3) years (range 24-77 years, 81% [26/32] male). Overall, 375 of 512 (73.2%) questionnaires were completed, with 17 (53%) of the 32 participants adherent. Participant-reported usability was acceptable; the mean SUS score was 71.9 (95% CI 64.3-79.5) with high satisfaction of LogPAL usefulness and likelihood to recommend to other cancer survivors. CONCLUSIONS This single-arm prospective pilot study showed that LogPAL is a feasible, regularly used, accepted app for HNC survivors, justifying a full-scale pilot. Based on the findings from this study, future iterations will aim to improve usability and test intervention efficacy.
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Affiliation(s)
- Sewit Teckie
- Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.,Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Jeffrey Solomon
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
| | - Karthik Kadapa
- Center for Research Informatics & Innovation, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, United States
| | - Keisy Sanchez
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
| | - David Orner
- Academic Department of Radiation Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, United States.,Department of Radiation Medicine, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Dennis Kraus
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Dev P Kamdar
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Lucio Pereira
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Douglas Frank
- Department of Otolaryngology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States.,Department of Otolaryngology, Northwell Health Cancer Institute, Lake Success, NY, United States
| | - Michael Diefenbach
- Center for Health Innovations and Outcomes Research, Department of Medicine, Northwell Health, Manhasset, NY, United States
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ElKefi S, Asan O. How technology impacts communication between cancer patients and their health care providers: A systematic literature review. Int J Med Inform 2021; 149:104430. [PMID: 33684711 DOI: 10.1016/j.ijmedinf.2021.104430] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To ensure the well-being of their patients, health care providers (HCPs) are putting more effort into the quality of the communication they provide in oncology clinics. With the emergence of Health Information Technology (HIT), the dynamics between doctors and patients in oncology settings have changed. The purpose of this literature review is to explore and demonstrate how various health information technologies impact doctor-patient communication in oncology settings. METHOD A systematic literature review was conducted in 4 databases (PubMed, Cochrane, Web of Science, IEEE Xplore) to select publications that are in English, published between January 2009 and September 2020. This review reports outcomes related to the impacts of using health information technologies on doctor-patient communication according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Reviews and Meta-Analysis guidelines (PRISMA). RESULTS We identified 31 studies which satisfied the selection and eligibility criteria. The review revealed a diverse range of HIT used to support communication between cancer patients and their HCPs in oncology settings. Outcomes related to communication were examined to demonstrate how technology can improve access to care in clinical settings and online. When technology is used effectively to support patient knowledge and shared understanding, this increases the patient's satisfaction and ability to manage emotions, make decisions, and progress in their treatment, in addition to increasing social support and building a stronger therapeutic alliance based on shared knowledge and transparency between clinicians and patients. CONCLUSION Technology-based solutions can help strengthen the relationship and communication between patients and their doctors. They can empower the patient's well-being, help doctors make better decisions and enhance the therapeutic alliance between them. Thus, using technology to enhance communication in healthcare settings remains beneficial if its use is structured and target oriented. Future studies should focus on comparing in-depth the difference between outpatient and inpatient settings in terms of the efforts required and the extent of the impacts from both clinicians' and cancer patients' perspectives.
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Affiliation(s)
- Safa ElKefi
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, 07047, USA
| | - Onur Asan
- School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, 07047, USA.
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Wu D, Lowry PB, Zhang D, Parks RF. Patients' compliance behavior in a personalized mobile patient education system (PMPES) setting: Rational, social, or personal choices? Int J Med Inform 2020; 145:104295. [PMID: 33129124 DOI: 10.1016/j.ijmedinf.2020.104295] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 09/19/2020] [Accepted: 10/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE With the advancement of mobile technologies, patients can access medical and patient educational information anytime and anywhere. Computer-aided patient education has been advocated as a key means of interventions for improving patient knowledge and compliance (i.e., adherence). However, evidence of the efficacy of computer-aided patient education remains relatively limited. For example, little is known about how the latest mobile technologies influence patients' compliance intention and their actual compliance behavior. The objective of this study is to investigate patients' compliance intention and behavior using a personalized mobile patient education system (PMPES) as a novel technological intervention for patients based on rational choice theory (RCT) and the theory of planned behavior (TPB). MATERIALS AND METHODS We conducted a field survey with 125 actual patients in U.S. who obtained their patient education through PMPES while seeking medical treatment advice from their doctors. We used partial least squares (PLS) regression path modeling to test our model. RESULTS We found that, based on RCT, the benefits of compliance and cost/threat of noncompliance positively influenced intention toward treatment compliance; in contrast, costs of compliance negatively influenced intention toward treatment compliance. However, the benefits of noncompliance had no effect on intention toward treatment compliance. The results also indicated that intention toward treatment compliance, response efficacy, and self-efficacy related to TPB jointly influenced the degree of actual compliance behaviors. Social influence factors including subjective norms and descriptive norms had no influence on patients' actual treatment compliance behavior. CONCLUSION Overall, the research model explains 69.2 % of the variance in patients' actual compliance behavior. We find our model robust in using RCT as a key theoretical lens for the assessment of patients' compliance intention to follow medical recommendations enabled by the PMPES and delivered to mobile devices. The factors associated with RCT and TPB jointly influence patients' actual compliance behavior. Future mobile patient education programs should consider patients' age groups, mixed-gender groups, different medical settings, and cross-cultural contexts.
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Affiliation(s)
- Dezhi Wu
- University of South Carolina, 550 Assembly Street, Columbia, SC 29298, USA.
| | | | - Dongsong Zhang
- University of North Carolina, 9201 University City Blvd., Charlotte, NC 28223, USA.
| | - Rachida F Parks
- Quinnipiac University, 275 Mt Carmel Ave, Hamden, CT 06518, USA.
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Reuter-Oppermann M, Müller-Polyzou R, Wirtz H, Georgiadis A. Influence of the pandemic dissemination of COVID-19 on radiotherapy practice: A flash survey in Germany, Austria and Switzerland. PLoS One 2020; 15:e0233330. [PMID: 32437381 PMCID: PMC7241763 DOI: 10.1371/journal.pone.0233330] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/04/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has already changed our globalised world and its long-term impact is not yet known. It is apparent that businesses and institutions are increasingly affected. COVID-19 discussions often focus on intensive care units in hospitals. However, COVID-19 also effects life-saving and -prolonging radiotherapy for patients suffering from cancer. METHOD We have conducted a structured online survey among medical physicists in Germany, Austria and Switzerland from March 23rd to 26th 2020. In total 154 responses (82 completed, 72 partially completed) were analysed in the context of the COVID-19 dissemination. RESULTS 72.4% of the respondent's state that their processes are affected due to COVID-19, while the top three answers are longer processing times (54.2%), patient no-shows (42.5%) and staff reduction (36.7%). 75.8% expect further unavailability of their personnel in the upcoming weeks. All participants have already taken several measures, especially providing information for patients at the entrance (89.6%) or over the phone (73.6%), restricting access for accompanying persons (77.4%) and providing disinfectant at the entrance (72.6%). DISCUSSION The results presented in this article aim to support business continuity and risk management for radiotherapy centres to prepare for future challenges. The results show that most radiotherapy centres has implemented initial contingency measures, applying them pragmatically. The main problem however remains, that is the high risk of infection both for patients and medical personnel along with the associated risk of temporarily loss of personnel and ordered closure of business.
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Affiliation(s)
- Melanie Reuter-Oppermann
- Fachgebiet Wirtschaftsinformatik | Software & Digital Business, Technical University of Darmstadt, Darmstadt, Germany
| | - Ralf Müller-Polyzou
- Institut für Produkt- und Prozessinnovation, Leuphana Universität Lüneburg, Lüneburg, Germany
| | - Holger Wirtz
- Gemeinschaftspraxis für Strahlentherapie Singen-Friedrichshafen, Singen, Germany
| | - Anthimos Georgiadis
- Institut für Produkt- und Prozessinnovation, Leuphana Universität Lüneburg, Lüneburg, Germany
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