JMIR Publications

ABSTRACT

Background:

Mobile technologies are increasingly being used to manage chronic diseases, including cancer, with the promise of improving the efficiency and effectiveness of care. Among the myriad of mobile technologies in healthcare, we have seen an explosion of mobile apps. The rapid increase in digital health apps is not paralleled by a similar trend in usage statistics by clinicians and patients. Little is known about how much and in what ways mHealth apps are used by clinicians and patients for cancer care; whether sociodemographic variables affect their use of mHealth; and what patients’ and clinicians’ expectations of mHealth apps are.

Objective:

This article aims to describe the patient and clinician population that uses mHealth in cancer care by administering them an online survey, as well as to provide recommendations to app developers and regulators to generally increase the use and efficacy of mHealth apps.

Methods:

Through a cross-sectional online survey, we explored the current utilization rates of mHealth in cancer care and factors that explain differences in utilization by patients and clinicians across the USA and five different countries in Europe. In addition, we conducted an international workshop with more than 100 stakeholders and a roundtable with key representatives of international organizations of clinicians and patients to solicit feedback on the survey results and develop insights into mHealth app development practices.

Results:

A total of 1,033 patients and 1,116 clinicians participated in the survey. The proportion of cancer patients using mHealth (294/1,033, 28.46%) was far lower than that of clinicians (859/1,116, 76.97%). Accounting for age and salary level, that impact on the adoption of mHealth, the marginal probabilities of use at means are still significantly different between the two groups (all P values <0.01) and were 69.8% for clinicians and 38.7% for patients using the PSBRA technique. Moreover, based on the intensity of use our analysis identified a gap between basic and advanced users, with a prevalent use for activities related to the automation of processes and the interaction with other individuals and a limited adoption for side-effects management and compliance monitoring in both groups.

Conclusions:

The full promise of mHealth for cancer care has yet to be realized and warrants more research and investment. Policies to promote telehealth/mHealth will not succeed unless the attitudes of physicians and their patients are adequately addressed. Given the professional divide we observed, there is merit in incentivising oncologists to adopt cancer apps in routine practice to encourage patients to access mHealth at greater length. If the promise of mHealth is to be fulfilled, clinician and patient usage rates will need to converge. Ideally, cancer apps should be designed in ways that strengthen the patient-physician relationship, ease physicians’ workload, and fit the criteria for reimbursement. Clinical Trial: n.a.