Symptom Assessment App Empowers Patient-Clinician Communication

A symptom assessment app used at home may empower education and self-management among patients, and help with clinician communication, according to a study presented at the Oncology Nursing Society's 43rd Annual Congress.

“Standardized symptom and quality of life assessments and interventions have been developed and used widely in research studies to measure outcomes of treatments and interventions,” said Nina Grenon, DNP, AOCN, adult geriatric nurse practitioner, Dana-Farber Cancer Institute.

She added that these assessments have clinical benefits, such as to increase the depth of conversation and patient-reported well-being during clinic visits; to increase treatment of psychosocial issues and symptoms; to reduce cancer symptom distress; and to lengthen survival among patients with advanced disease.

Previous research has showed that technology, such as using computers, tablets, and smart phones, can be effective in reducing symptom distress and depression; however, little is known about feature-specific use in particular.

“Can we add a direct patient-to-clinician messaging component?” Grenon questioned. “Which features of such a program are utilized remotely most often? How often will patients use it? What do patients and clinicians think about it?

In a single-arm, pilot study, Grenon and colleagues determined the feasibility of the iCancerHealth^® app as a patient education aide regarding cancer symptoms and medication management. They aimed to evaluate enrollment rates, utilization rates over a 2-month period, patient acceptability, and clinician satisfaction with the provider-side application.

Patients engaged with the app at home, and registered using the platform to complete the symptom assessment in clinic at baseline. Then, from home, the participants reported symptoms, and would receive management information tailored to the level of symptom severity, also while receiving communication from their clinician as needed.

Meanwhile, clinicians received alerts and communicated using the provider side of the app, called Medocity MD^®.

Participants were called weekly, or met in person during a regular clinic visit. In addition, they were reminded weekly to use the app and to perform a last symptom report 4-6 weeks later.

The majority of patients (median age, 50 years) were white males, who were employed, married, and had education that consisted of some college or higher. Most participants used computers and smart phones very often, and had downloaded a health app before.

In total, 53 participants accessed at least 1 feature at least once from home. The most frequently used feature was the “Symptom Tracker” (n = 49; 86%), followed by the “My Inbox” (n = 36; 63%), and “My Medications” (n = 34; 60%) features.

The app appeared to be acceptable among participants, demonstrating an overall median E-acceptability scale score of 25.5 (range, 12-30). Clinicians also reported that the app was most acceptable with regard to facilitating in-person interactions that occurred after app use.

“The technology is feasible, and it can educate patients to become more confident and empower self-management of symptoms,” Grenon said. “The technology needs to be embedded within specific electronic medical records and needs testing in the elderly and other high-risk populations.”

Reference

Grenon N, Blonquist T, Nayak M, Momani T, McCleary N, Berry D. Self-care support for patients with gastrointestinal cancer: iCancerHealth. Presented at: ONS 43rd Annual Congress; May 17-20, 2018; Washington, DC. https://ons.confex.com/ons/2018/meetingapp.cgi/Paper/1945