Mixed methods study of the feasibility and acceptability of remote monitoring of lung cancer patient-reported outcomes.

Abstract

341 Background: Symptom monitoring using electronic patient-reported outcome (ePRO) systems during cancer care has been shown to provide clinical benefits and is now recommended for routine care. Integrating existing ePRO platforms into practices may lower costs and logistical barriers to use. The purpose of this study was to assess the feasibility and acceptability of a mobile app (Moovcare) for care of patients with lung cancer. Methods: In this single-site study, patients on treatment for lung cancer were recruited for 6 months of ePRO monitoring using Moovcare, an application originally designed for patients undergoing surveillance. Patients reported symptoms weekly via a survey delivered to their email address. Providers received email alerts for concerning symptoms and accessed graphical reports displaying responses over time. Providers were asked to complete an interview after 6 months of experience using Moovcare. Feasibility was assessed by the % of surveys completed per patient. Clinician acceptability was evaluated using semi-structured interviews. Results: 90 patients were recruited to participate and 46/90 (51.1%) were enrolled. 41/46 (89%) completed at least 1 survey. Patients were a mean 61.5 years of age. The majority were female (61.0%), White (73.2%), and had advanced NSCLC (92.7%). Nearly half (43.9%) had completed at least college level education. Most reported daily internet (87.8%) and email (63.4%) use. Survey completion rates are in Table 1. Alerts occurred in 78.0% of participants, with a mean of 4.2 alerts (SD=4.7) per patient. Alerts were closed by providers in a mean 2.7 days (SD=3.9). 3/7 providers participated in alert management, all of whom participated in interviews. These providers felt there was potential value for Moovcare to monitor symptoms but did find enrolled patients were already proactive about contacting the clinic for symptom management. Most interviewed providers (66.0%; 2/3) would like to use the system again and would recommend the system to others. EMR integration was strongly desired to improve workflow. Conclusions: ePRO survey completion and alert management using an existing web-based application were feasible for lung cancer patients and their providers. While concerning symptoms were commonly experienced by patients, provider perceptions of alert utility were low. Adjusting alert criteria to increase the frequency of actionable alerts and using strategies to increase ePRO use in patients with low participation levels may increase the utility of ePROs. EMR integration may improve acceptability to providers. Clinical trial information: NCT05011890 .[Table: see text]