Use of a Mobile Application for Monitoring Patient-Reported Outcomes in Cancer Care A Prospective Randomized Feasibility Study

Abstract

Introduction
There is still under treatment of cancer symptoms and our local data shows that a significant number of cancer patients seen in our center needed consultation outside scheduled visits (53%) and needed urgent care (31%) for symptom control. A mobile application was developed to address the need for timely symptom reporting of patients. Despite the success of similar innovations in the United States, its feasibility in the local context is still unknown and its perceived benefits might not translate in our setting.

Purpose
The objective of this study was to evaluate the feasibility of using a mobile application for monitoring patient self-reported symptoms.

Methodology
We conducted a single-institution randomized prospective study to evaluate the feasibility of using a mobile application to allow cancer patients with pain to report symptoms using their mobile device. Cancer patients seen at our center with pain score ≥4 were randomly assigned to report symptoms daily with the use of the mobile application or to receive usual care consisting of symptom monitoring with a pain diary at the discretion of the attending physicians. Clinicians reviewed patient-reports during clinic visits. The primary outcome measure of the study was patient compliance with symptom reporting at the end of 4 weeks evaluation. Compliance is defined as the number of days with a symptom report over the total number of days on study.

Results
A total of 41 patients underwent screening and informed consent process. After exclusion, 22 were enrolled and analyzed. Mean age was 52 (25-89), majority had curative intent treatment (63.6%), underwent radiotherapy with or without chemotherapy (86.4%) and had non-severe pain (59%). Reporting compliance was significantly higher for patients in the mobile application arm than in usual care (mean compliance 72.1% in mobile app arm vs 42.1% in usual care arm, P=0.0054).

Conclusion
We conclude that the use of a mobile application for patient self-reporting of cancer symptoms is feasible in an urban based cancer center and resulted to higher reporting compliance compared to usual care. We recommend that its clinical impact be further evaluated in a larger trial.