Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: May 20, 2020
Date Accepted: Sep 13, 2020
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Impact of a mobile application on the pharmacotherapeutic follow-up of cancer patients
ABSTRACT
Background:
Oral antineoplastic agents (OAAs) have revolutionized cancer management. However, they are not exempt from adverse effects, lack of adherence, and drug-drug interactions. In this sense, mobile applications (apps) can increase patient autonomy, allowing remote and real-time pharmacotherapeutic monitoring.
Objective:
To analyze the impact on health outcomes of a mobile app for the pharmacotherapeutic follow-up of oncohematological patients undergoing treatment with oral antineoplastic drugs. The secondary objectives were to analyze the role of the app in communication with health care professionals and patient satisfaction with the app.
Methods:
We performed a comparative, quasi-experimental study based on a pre-post intervention. The study population comprised 101 patients (51 patients in the control group [traditional pharmacotherapeutic follow-up] vs. 50 patients in the intervention group [pharmacotherapeutic follow-up through e-Oncosalud® app]). e-OncoSalud® is a custom-designed app to promote home pharmacotherapeutic follow-up and the safety of patients treated with OAAs. The impact of the app on drug safety, adherence to treatment, and quality of life was evaluated.
Results:
Drug safety: In the control group, 72.5% of the patients presented drug-related problems vs. 70.0% of the intervention group (p=.01). The probability of detecting an insufficiently treated health problem was higher in the intervention group (p=0.038). The percentage of patients who presented side effects was lower in the group that used the app (90% vs. 100%; p= 1.01). In the control group, 49% of the patients consumed some health resources during the first 6 months of treatment, compared with 36% in the intervention group (p=.76). Adherence to treatment: Adherence was 97.6% (SD = 7.9) in the intervention group, that is, higher than in the control group (92.9%, [SD = 10.0]; p<.02). Health-related quality of life: The average EQ-5D in the intervention group yielded an index of 0.875 (SD = 0.156), which was higher than in the control group (0.741 [SD = 0.177]; p<.001). Communication: Sixty percent of patients used the messaging module to communicate with pharmacists. The most frequent types of messages were acknowledgment of the attention received (27.2%) (77/283), doubts about contraindications and interactions with OAAs (24.7%) (70/283) and consultations for adverse reactions to treatment (13.8%) (39/283). Satisfaction with the app: The satisfaction survey conducted in the intervention group yielded an overall score of 9.1 (SD = 0.4) out of 10.
Conclusions:
Use of the app for the real-time pharmacotherapeutic follow-up of patients under treatment with OAAs made it possible to optimize health outcomes. The app also led to a reduction in drug-related problems and resource consumption, an increase in adherence to treatment, and an improvement in health-related quality of life.
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