Abstract
BackgroundMobile health (mHealth) technologies are increasingly used in various medical fields. However, the potential of mHealth to improve patient care in radiotherapy by acquiring electronic patient reported outcome measures (ePROMs) during treatment has been poorly studied so far.ObjectiveThe aim of this study was to develop and implement a novel Web app (PROMetheus) for patients undergoing radiotherapy. Herein, we have reported our experience with a focus on feasibility, patient acceptance, and a correlation of ePROMs with the clinical course of the patients.MethodsIn the period between January and June 2018, 21 patients used PROMetheus to score side effects, symptoms, and quality of life–related parameters during and after their treatment. Items of the Patient Reported Outcome version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE) were chosen based on the primary site of disease, 27 items for head and neck tumors, 21 items for thoracic tumors, and 24 items for pelvic tumors.ResultsIn total, 17 out of the 21 patients (81%) regularly submitted ePROMs and more than 2500 data points were acquired. An average of 5.2, 3.5, and 3.3 min was required to complete the head and neck, thorax, and pelvis questionnaires, respectively. ePROMS were able to detect the occurrence of both expected and unexpected side effects during the treatment.In addition, a gradual increase in the severity of side effects over the course the treatment and their remission afterward could be observed with ePROMs. In total, 9 out of the 17 patients (53%), mostly those with head and neck and thoracic cancers, reported PRO-CTCAE grade III or IV fatigue with severe impairments of activities of daily life.ConclusionsThis study shows the successful implementation of an ePROM system and a high patient acceptance. ePROMs have a great potential to improve patient care in radiotherapy by providing a comprehensive documentation of symptoms and side effects, especially of ones that are otherwise underreported.
Highlights
Mobile Health and Patient Reported OutcomesMobile health is a rapidly growing field and has, according to the World Health Organization, the potential to transform the face of health service delivery across the globe [1]
Data regarding the use of electronic patient-reported outcome measure Integrated Mobile Health Research Platform (IMeRa) (ePROM) are sparse despite surveys showing a considerable interest to use mobile technologies in clinical practice, both on the caregiver and patient side [12,13]
We report our initial experience with a focus on feasibility, patient acceptance, and a correlation of ePROMs with the clinical course of the patients
Summary
Mobile Health and Patient Reported OutcomesMobile health (mHealth) is a rapidly growing field and has, according to the World Health Organization, the potential to transform the face of health service delivery across the globe [1]. It has been shown that the data acquired do not differ between a traditional paper- and pencil-based assessment and an acquisition via ePROMs [10] This was again validated by Matthies et al, who reported highly significant correlations between a paper-based version of the Functional Assessment of Cancer Therapy—Breast questionnaire and an electronic version designed for breast cancer patients [11]. The potential of mHealth to improve patient care in radiotherapy by acquiring electronic patient reported outcome measures (ePROMs) during treatment has been poorly studied so far. A gradual increase in the severity of side effects over the course the treatment and their remission afterward could be observed with ePROMs. In total, 9 out of the 17 patients (53%), mostly those with head and neck and thoracic cancers, reported PRO-CTCAE grade III or IV fatigue with severe impairments of activities of daily life. Conclusions: This study shows the successful implementation of an ePROM system and a high patient acceptance. ePROMs have a great potential to improve patient care in radiotherapy by providing a comprehensive documentation of symptoms and side effects, especially of ones that are otherwise underreported
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