Patient interactive digital support for women with adjuvant endocrine therapy in order to increase compliance and quality of life

Abstract

Purpose: The primary aim of the study was to develop and investigate a patient interactive digital support (an app) for patients on adjuvant endocrine breast cancer treatment. Patient's interactive digital applications are a fast-growing area for research and development. In general, patients want more information and support with regard to their diagnosis, treatment and self-care. At the same time, the health care system has limited resources for follow-up. Our primary endpoints were usability of the app and if it added any value to the patients.

Methods: We designed and constructed a prototype, in dialogue with patients, containing four main modules for registration of drug compliance, performed physical exercise, self-care activities, and questions on health and quality of life. The app was then tested by patients and improved further before we completed a pilot study in which 15 patients used the app for 3 months.

Results: Patients perceived the app easy to use with a very high median system usability score of 88.8, range 30-100. The 15 women registered in total 4251 times, range 118 to 372. The majority of registrations concerned compliance (adherence to treatment) and physical exercise.

Conclusion: The app was perceived easy to use and of support in every-day life of breast cancer survivors. How to best integrate electronically collected patient reported outcome measures in clinical routine needs to be further studied, and future research will show if it will be cost-effective in terms of better health outcome and less resource use.

Keywords: Adjuvant; Breast cancer; Compliance; Digital support; Endocrine; Patient reported outcome measures; Quality of life; Treatment.

Conflict of interest statement

The project to develop the solution was a joint venture between the Capio St Gorans hospital, ScientificMed and AstraZeneca and Novartis Sweden. It was supported with grants from the Region of Stockholm Innovation fund and with a sponsorship agreement from Novartis and AstraZeneca.

Figures

Fig. 1

Patient interface of the application

Fig. 2

System usability score (SUS) of the study in comparison with literature: Usability.gov –Digital Communications Division in the U.S. Department of Health and Human Services’ (HHS) Office of the Assistant Secretary for Public Affairs; Bangor, A., Kortum, P. T., & Miller, J. T. (2009). Determining what individual SUS scores mean: Adding an adjective rating scale. Journal of Usability Studies, 4 [3], 114–123; Sauro, J. (2011). A practical guide to the System Usability Scale: Background, benchmarks, & best practices. Denver, CO: MeasuringUsability LLC

Fig. 3

Total use of the digital application

Fig. 4

Registrations in module “My well-being”

Fig. 5

Registrations of drug-adherence in module “Endocrine therapy”

Fig. 6

Registrations in module “Physical exercise”

Fig. 7

Registrations of “Self-care activities”