Abstract
Real-time reporting of patient-reported cancer radiation treatment symptoms via mobile app or computer-based system can improve communication with the Clinical Care Team (CCT) however single-purpose solutions can be impractical. This study describes use of multifunction software and associated patient satisfaction. Patients receiving thoracic, pelvic, or bone radiation therapy at a provincial cancer agency were asked to enroll and receive training on app use. Clinical teams can send tailored educational materials (12 PDFs, 1 file linking patients to facility resources pertinent to treatment). During active treatment, the CCT also uses the software to administer the Edmonton Symptom Assessment System (ESAS) questionnaire once weekly for 4 consecutive weeks. Patients can also complete it ad hoc. The ESAS asks patients to report function across 10 domains using an 11-point scale (range 0-10); the version within the app is enhanced by programmed clinical alerts correlated to the response. When patients report pain, nausea, shortness of breath, or depression as a 7 or 8, then the response is flagged as "urgent"; if patients report a 9 or 10 then it is an "emergency". All the other items are considered "urgent" if the patient reports a 9 or 10. Upon completing the questionnaire, patients with flagged responses receive programmed recommendations, and a CCT member follows up with further instructions. Additionally, the software triages patient responses in order of urgency on the CCT's dashboard. Patients also have ad hoc use of a diary, to record any personal information, and the ability to securely communicate medical and non-medical information with the CCT. Patient satisfaction with the software was assessed by randomly asking patients with active accounts >30 days, "How likely are you to recommend (software name) to another patient" using an 11-point scale. Data for 180 days of software use were downloaded (Jan. 17) and analyzed descriptively. Patients (n = 1,647) were sent educational information and 69.94% opened the files in less than 1 day; the median time to open was 2 hours. The ESAS was completed by 561 patients a total of 2,452 times (mean = 4.37). The CCT received 39 (1.59%) emergency alerts and 299 (12.19%) urgent alerts. The diary and secure communication features were used by 5.32% of patients. The mean satisfaction score was 7.87 (n = 176); 88 patients (50.00%) rated the app a 9 (n = 17; 9.66%) or 10 (n = 71; 40.34%). The implementation of patient-facing multifunction software to those receiving radiation has, so far, been a success because it complements standard treatment care, facilitates CCT-patient partnership, enhances continuity of care, and is well-liked by patients.
Published Version
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