Provision of smartphones in a symptom monitoring program of gynecologic and breast cancer patients during active therapy.

Abstract

255 Background: With advances in technology, smartphones are being used for multiple research and clinical care functions. However, not all patients have these devices, leading to disparities in participation. We report on a quality improvement program that provided smartphones to patients without these devices. Methods: Gynecologic (n = 120) and breast (n = 193) cancer patients under active treatment were enrolled in a 12-month text-based symptom monitoring program to facilitate communication and optimize patient management. Patients without a smartphone were provided with an iPhone through a partnership with a U.S. wireless company. The company provided smartphone devices at zero cost, and program funds paid for 12 months of phone service. Program staff helped patients set up the iPhones, and provided basic education and ongoing phone support. After 12 months, patients were able to keep their iPhones, but had to secure their own phone plan for calling and texting functions. Results: iPhones were provided to 42 (13.4%) patients across all cancer types. Patients who received iPhones, compared with those who had a smartphone, had incomes below $50,000/year (p = 0.03) and an educational level of < high school (p < 0.0001). Program staff had few difficulties training patients to operate the phones or in patients’ adherence to symptom monitoring after receiving the iPhones. Phone service charges averaged $40 per month or $500 per person for 12 months. Greater than 90% of patients believed the phones enabled them to better communicate with their health care team and family/support networks, and 95% believed the phones had a positive impact on their life. However, only 70% planned on getting a phone service plan at the end of the 12 months, due to cost or believing a smartphone was not a necessity. Conclusions: Providing smartphones to patients enabled them to better communicate with their health care team and families, and participate in remote symptom monitoring during active treatment. Programs such as these are needed to reduce disparities in patient care, and support quality improvement efforts using electronic devices.