Do mHealth applications improve clinical outcomes of patients with cancer? A critical appraisal of the peer-reviewed literature

Jemima Osborn, Anu Ajakaiye, Tim Cooksley, Christian P Subbe, Jemima Osborn, Anu Ajakaiye, Tim Cooksley, Christian P Subbe

Abstract

Purpose: Patients undergoing systemic anti-cancer treatment experience distressing side effects, and these symptoms are often experienced outside the hospital setting. The impact of usage of cancer-related mobile health (mHealth) applications on patient-related outcomes requires investigation.

Methods: A critical appraisal of the literature was performed for the following question: 'In patients with cancer have mHealth applications been compared with usual care to examine impact on commonly used clinical outcomes'. Literature searches were undertaken with the help of a research librarian and included Medline, Cochrane Collaboration, clinical trial databases and grey searches.

Results: Seventeen studies including between 12 and 2352 patients were identified and reviewed. Smartphone applications or internet portals collected data on symptoms or patient activity. Several studies showed statistically significant differences in patient-reported outcomes when symptom monitoring using mobile health application was compared to usual care. Change in mobility was the only outcome that was related directly to toxicity. Only limited data on mortality, cancer-related morbidity including complications of care, health-economic outcomes or long-term outcomes were reported.

Conclusions: Studies on mHealth applications might improve aspects of symptom control in patients with cancer, but there is currently little evidence for impact on other outcomes. This requires future research in interventional studies.

Keywords: Cancer; Health-related quality of life; Internet; Smartphone; mHealth.

Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram of literature search

References

    1. Cooksley T, Rice T. Emergency oncology: development, current position and future direction in the USA and UK. Support Care Cancer. 2017;25(1):3–7.
    1. Hibbard J Helen G (2014) Supporting people to manage their health : an introduction to patient activation. The King’s Fund, London
    1. World Health Organization (2011) mHealth: new horizons for health through mobile technologies: second global survey on eHealth Vol. 3, Global Observatory for eHealth series, the World Health Organisation
    1. Jahns R-G, Houck P (2013) Mobile health market - trends and figures 2013–2017. Berlin
    1. UK (2016) “Has never been more addicted to smartphones” - BBC news [internet]. [cited 2018 Jul 21]. Available from: . Accessed 21 June 2018
    1. Mobasheri MH, King D, Johnston M, Gautama S, Purkayastha S, Darzi A. The ownership and clinical use of smartphones by doctors and nurses in the UK: a multicentre survey study. BMJ Innov. 2015;1(4):174–181.
    1. McKay FH, Cheng C, Wright A, Shill J, Stephens H, Uccellini M. Evaluating mobile phone applications for health behaviour change: a systematic review. J Telemed Telecare. 2018;24(1):22–30.
    1. Haase J, Farris KB, Dorsch MP. Mobile applications to improve medication adherence. Telemed e-Health. 2017;23(2):75–79.
    1. Iribarren SJ, Cato K, Falzon L, Stone PW. What is the economic evidence for mHealth? A systematic review of economic evaluations of mHealth solutions. Mihalopoulos C, editor. PLoS One. 2017;12(2):e0170581.
    1. Theile G, Klaas V, Tröster G, Guckenberger M. mHealth technologies for palliative care patients at the interface of in-patient to outpatient care: protocol of feasibility study aiming to early predict deterioration of patient’s health status. JMIR Res Protoc. 2017;6(8):e142.
    1. Nasi G, Cucciniello M, Guerrazzi C. The role of mobile technologies in health care processes: the case of cancer supportive care. J Med Internet Res. 2015;17(2):e26.
    1. Davis SW, Oakley-Girvan I. mHealth education applications along the cancer continuum. J Cancer Educ. 2015;30(2):388–394.
    1. Geng Y, Myneni S. Patient engagement in cancer survivorship care through mHealth: a consumer-centered review of existing mobile applications. AMIA Annu Symp Proc AMIA Symp. 2015;2015:580–588.
    1. Nasi G, Cucciniello M, Guerrazzi C. The performance of mHealth in cancer supportive care: a research agenda. J Med Internet Res. 2015;17(1):e9.
    1. Chen J, Ou L, Hollis SJ. A systematic review of the impact of routine collection of patient reported outcome measures on patients, providers and health organisations in an oncologic setting. BMC Health Serv Res. 2013;13(1):211.
    1. Catt S, Starkings R, Shilling V, Fallowfield L. Patient-reported outcome measures of the impact of cancer on patients’ everyday lives: a systematic review. J Cancer Surviv. 2017;11(2):211–232.
    1. Gotay CC, Kawamoto CT, Bottomley A. The prognostic significance of patient-reported outcomes in cancer clinical trials. Artic J Clin Oncol. 2008;26:1355–1363.
    1. Callander J, Anstey AV, Ingram JR, Limpens J, Flohr C, Spuls PI. How to write a critically appraised topic: evidence to underpin routine clinical practice. Br J Dermatol. 2017;177(4):1007–1013.
    1. Rosen KD, Paniagua SM, Kazanis W, Jones S, Potter JS. Quality of life among women diagnosed with breast cancer: a randomized waitlist controlled trial of commercially available mobile app-delivered mindfulness training. Psychooncology. 2018;27(8):2023–2030.
    1. Golsteijn RHJ, Bolman C, Volders E, Peels DA, de Vries H, Lechner L. Short-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: a randomized controlled trial. Int J Behav Nutr Phys Act. 2018;15(1):106.
    1. Zou Q, Zhang G, Liu Y. Health education using telephone and WeChat in treatment of symptomatic uterine myoma with high-intensity focused ultrasound. Med Sci Monit Basic Res. 2018;24:127–133.
    1. Aljabri D, Dumitrascu A, Burton MC, White L, Khan M, Xirasagar S, Horner R, Naessens J. Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction. BMC Med Inform Decis Mak. 2018;18(1):70.
    1. Jibb LA, Stevens BJ, Nathan PC, Seto E, Cafazzo JA, Johnston DL, et al. Implementation and preliminary effectiveness of a real-time pain management smartphone app for adolescents with cancer: a multicenter pilot clinical study. Pediatr Blood Cancer. 2017;64(10):1–9.
    1. Smith SK, Kuhn E, O’Donnell J, Koontz BF, Nelson N, Molloy K, et al. Cancer distress coach: pilot study of a mobile app for managing posttraumatic stress. Psychooncology. 2018;27(1):350–353.
    1. Foley N, O’Connell E, Lehane E, Livingstone V, Maher B, S K, et al. PATI: patient accessed tailored information: a pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application. Breast. 2016;30:54–58.
    1. Soto-Perez-De-Celis E, Kim H, Rojo-Castillo MP, Sun C-L, Chavarri-Guerra Y, Navarrete-Reyes AP, et al. A pilot study of an accelerometer-equipped smartphone to monitor older adults with cancer receiving chemotherapy in Mexico. J Geriatr Oncol. 2018;9(2):145–151.
    1. Uhm KE, Yoo JS, Chung SH, Lee JD, Lee I, Kim JI, et al. Effects of exercise intervention in breast cancer patients: is mobile health (mHealth) with pedometer more effective than conventional program using brochure? Breast Cancer Res Treat. 2017;161(3):443–452.
    1. Kanera IM, Willems RA, Bolman CAW, Mesters I, Verboon P, Lechner L. Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial. Int J Behav Nutr Phys Act. 2017;14(1):19.
    1. Wheelock AE, Bock MA, Martin EL, Hwang J, Lou EM, Rugo HS, et al. : a randomized controlled trial evaluating a web-based system for symptom management after treatment of breast cancer. Cancer. 2015;121(6):893–899.
    1. Denis F, Viger L, Charron A, Voog E, Dupuis O, Pointreau Y, Letellier C. Detection of lung cancer relapse using self-reported symptoms transmitted via an internet web-application: pilot study of the sentinel follow-up. Support Care Cancer. 2014;22(6):1467–1473.
    1. Basch E, Deal AM, Kris MG, Scher HI, Hudis CA, Sabbatini P, Rogak L, Bennett AV, Dueck AC, Atkinson TM, Chou JF, Dulko D, Sit L, Barz A, Novotny P, Fruscione M, Sloan JA, Schrag D. Symptom monitoring with patient-reported outcomes during routine cancer treatment: a randomized controlled trial. J Clin Oncol. 2016;34(6):557–565.
    1. Sundberg K, Wengström Y, Blomberg K, Hälleberg-Nyman M, Frank C, Langius-Eklöf A. Early detection and management of symptoms using an interactive smartphone application (Interaktor) during radiotherapy for prostate cancer. Support Care Cancer. 2017;25(7):2195–2204.
    1. Berry DL, Hong F, Halpenny B, Partridge A, Fox E, Fann JR, Wolpin S, Lober WB, Bush N, Parvathaneni U, Amtmann D, Ford R. The electronic self report assessment and intervention for cancer: promoting patient verbal reporting of symptom and quality of life issues in a randomized controlled trial. BMC Cancer. 2014;14(1):513.
    1. Kolb NA, Smith AG, Singleton JR, Beck SL, Howard D, Dittus K, Karafiath S, Mooney K. Chemotherapy-related neuropathic symptom management: a randomized trial of an automated symptom-monitoring system paired with nurse practitioner follow-up. Support Care Cancer. 2018;26(5):1607–1615.
    1. Foley NM, O’Connell EP, Lehane EA, Livingstone V, Maher B, Kaimkhani S, et al. PATI: patient accessed tailored information: a pilot study to evaluate the effect on preoperative breast cancer patients of information delivered via a mobile application. Breast. 2016;30:54–58.
    1. Basch E, Deal AM, Dueck AC, Scher HI, Kris MG, Hudis C, Schrag D. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017;318(2):197–198.
    1. Fortier MA, Chung WW, Martinez A, Gago-Masague S, Sender L. Pain buddy: a novel use of m-health in the management of children’s cancer pain. Comput Biol Med. 2016;76(December):202–214.
    1. Pham Q, Wiljer D, Cafazzo JA. Beyond the randomized controlled trial: a review of alternatives in mHealth clinical trial methods. JMIR mHealth uHealth. 2016;4(3):e107.
    1. Hoilett OS, Twibell AM, Srivastava R, Linnes JC (2018) Kick LL: A smartwatch for monitoring respiration and heart rate using photoplethysmography. Conf Proc IEEE Eng Med Biol Soc 2018:3821–3824
    1. Pope Z, Zeng N, Zhang R, Lee H, Gao Z. Effectiveness of combined smartwatch and social media intervention on breast cancer survivor health outcomes: a 10-week pilot randomized trial. J Clin Med. 2018;7(6):140.
    1. Cox A, Lucas G, Marcu A, Piano M, Grosvenor W, Mold F, Maguire R, Ream E. Cancer survivors’ experience with telehealth: a systematic review and thematic synthesis. J Med Internet Res. 2017;19(1):e11.
    1. Williams OE, Elghenzai S, Subbe C, Wyatt JC, Williams J. The use of telemedicine to enhance secondary care: some lessons from the front line. Futur Hosp J. 2017;4(2):109–114.
    1. Avery KNL, Richards HS, Portal A, Reed T, Harding R, Carter R, Bamforth L, Absolom K, O’Connell Francischetto E, Velikova G, Blazeby JM. Developing a real-time electronic symptom monitoring system for patients after discharge following cancer-related surgery. BMC Cancer. 2019;19(1):463.
    1. Holch P, Warrington L, Bamforth LCA, Keding A, Ziegler LE, Absolom K, Hector C, Harley C, Johnson O, Hall G, Morris C, Velikova G. Development of an integrated electronic platform for patient self-report and management of adverse events during cancer treatment. Ann Oncol. 2017;28(9):2305–2311.
    1. Warrington L, Absolom K, Holch P, Gibson A, Clayton B, Velikova G. Online tool for monitoring adverse events in patients with cancer during treatment (eRAPID): field testing in a clinical setting. BMJ Open. 2019;9(1):e025185.
    1. Maguire R, Fox PA, McCann L, Miaskowski C, Kotronoulas G, Miller M, Furlong E, Ream E, Armes J, Patiraki E, Gaiger A, Berg GV, Flowerday A, Donnan P, McCrone P, Apostolidis K, Harris J, Katsaragakis S, Buick AR, Kearney N. The eSMART study protocol: a randomised controlled trial to evaluate electronic symptom management using the advanced symptom management system (ASyMS) remote technology for patients with cancer. BMJ Open. 2017;7(5):e015016.
    1. Breen S, Ritchie D, Schofield P, Hsueh Y, Gough K, Santamaria N, et al. The Patient Remote Intervention and Symptom Management System (PRISMS) – a telehealth- mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies: study protocol for a randomised controlled trial. Trials. 2015;16(1):472.
    1. Collado-Borrell R, Escudero-Vilaplana V, Ribed-Sánchez A, Ibáñez-García S, Herranz-Alonso A, Sanjurjo-Sáez M. Smartphone applications for cancer patients; what we know about them? Farm Hosp. 2016;40(1):25–35.
    1. Weaver A, Love SB, Larsen M, Shanyinde M, Waters R, Grainger L, Shearwood V, Brooks C, Gibson O, Young AM, Tarassenko L. A pilot study: dose adaptation of capecitabine using mobile phone toxicity monitoring — supporting patients in their homes. Support Care Cancer. 2014;22(10):2677–2685.
    1. Kessel KA, Vogel MM, Kessel C, Bier H, Biedermann T, Friess H, et al. Mobile health in oncology: a patient survey about app-assisted cancer care. JMIR mHealth uHealth. 2017;5(6):e81.
    1. Subbe CP, Øvretveit J, Quinn N, Wyatt JC. DIGITAL TECHNOLOGY: opportunities and barriers for usage of personal health records in hospital – report from a ­workshop of the Health Informatics Unit at the Royal ­College of Physicians. Futur Hosp J. 2019;6(1):52–56.
    1. Buccheri S, Sarno G, Fröbert O, Gudnason T, Lagerqvist B, Lindholm D, Maeng M, Olivecrona G, James S. Assessing the nationwide impact of a registry-based randomized clinical trial on cardiovascular practice. Circ Cardiovasc Interv. 2019;12(3):e007381.
    1. Sundh J, Bornefalk-Hermansson A, Ahmadi Z, Blomberg A, Janson C, Currow DC, McDonald CF, McCaffrey N, Ekström M (2019) REgistry-based randomized controlled trial of treatment and Duration and mortality in long-term OXygen therapy (REDOX) study protocol. BMC Pulm Med 19(1):50

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться