Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Dec 11, 2019
Date Accepted: May 14, 2020
Date Submitted to PubMed: May 19, 2020
The Effect of Mobile Application for Symptom Management on Quality of Life During Systemic Treatment in Early Breast Cancer
ABSTRACT
Background:
Providing cancer patients undergoing systemic therapy with useful information about symptom management is essential to prevent deterioration of quality of life (QoL).
Objective:
In our study, we tested the impact of a mobile phone application for symptom management on the quality of life and use of health resources.
Methods:
We conducted a prospective cohort study evaluating QoL in early breast cancer patients receiving systemic therapy in an outpatient setting at the Institute of Oncology Ljubljana, Slovenia. The mobile group (n=46) was provided with a mobile application for Android smartphones and received the usual care, while the control group (n=45) received the usual care only. The mobile application supported daily tracking of 50 symptoms and grading their severity (mild, moderate or severe) along with in-depth descriptions and recommendations for patients depending on symptom grade. Patient-related outcomes in both groups were assessed through the European Organisation for Research and Treatment of Cancer (EORTC) C-30 and BR-23 questionnaires, as well as Health Resource Usage Questionnaire at baseline, after the 1st week, after the 1st cycle and at the end of treatment. The primary goal was to assess the difference between groups in the global quality of life and the summary score of the EORTC C-30 questionnaire after the 1st week, after the 1st cycle and at the end of treatment. Other scales were compared only exploratory. The secondary outcome was the use of health resources.
Results:
The mean difference between the groups in the global quality of life after the 1st week was 10.1 (95% confidence interval (CI) [1.8, 18.5], P=.02) when adjusted for value at baseline and type of surgery. The summary score was statistically significantly better in the mobile group than in the control group after the 1st week (adjusted mean 8.9, 95% CI [3.1, 14.7], P=.003) and at the end of treatment (adjusted mean 10.6, 95% CI [3.9, 17.3], P=.002). The use of health resources (visits to the doctor and hospitalizations) was statistically not significantly different between the groups (in the 1st week: P=.12; in the 1st cycle: P=.13).
Conclusions:
The use of the mobile application enabled patients undergoing systemic therapy to cope better with symptoms as indicated by a better global quality of life and summary score after the 1st week and by a better summary score at the end of treatment in comparison to the control group, but we have not found a significant impact on the use of health resources. Clinical Trial: EUDRACT protocol number 2018-001869-16
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