JMIR Publications

ABSTRACT

Background:

Electronic symptom self-reporting systems (e-SRS) have demonstrated benefits to improve symptoms and survival in patients with cancer. However, patient engagement in using e-SRS for voluntary symptom self-reporting is less optimal. Multiple factors can potentially affect patients’ acceptance and engagement in using home-based e-SRS. While such factors have not been fully explored among cancer populations.

Objective:

This review aimed to understand cancer patients’ acceptance and use of home-based e-SRS and identify associated facilitators/barriers.

Methods:

PubMed, CINAHL, Scopus, and PsycINFO (January 2010 - March 2020) were searched using a combination of MeSH terms and keywords: symptom self-reporting, electronic/technology, cancer, and their synonyms. Included studies focused on the use of home-based e-SRS by patients with cancer and their families. Studies of patients’ use of e-SRS in clinical settings only were excluded. Factors associated with patient acceptance and use of e-SRS were extracted and synthesized.

Results:

Of 3740 articles retrieved, 33 remained for the final review. Most e-SRS were web-based (66%) or mobile app-based (27%). The e-SRS initial acceptance, represented by patient enrollment rates, ranged from 40 to 100%. High e-SRS acceptance was rated by 69-80% of patients after they used the system. The e-SRS use, measured by patient response rates to questionnaires (ranged from 45% to 92%) or system log-on rates (ranged from 33% to 99%), declined over time in general patterns. Few studies (n=7) reported e-SRS use beyond 6 months, with the response rates from 62-85.1% and the log-on rates from 63.6-77%. The availability of compatible devices and technical support, interactive system features, information accessibility, and privacy, questionnaire quality, patient physical/psychosocial status, and age were associated with patient acceptance and the use of home-based e-SRS.

Conclusions:

Cancer patients’ acceptance and use of home-based e-SRS varied significantly across studies, assessed by a variety of approaches. The lack of access to technology remained as a significant barrier to e-SRS adoption. Interactive system features and personalized questionnaires may increase patient engagement. More studies are needed to further understand patients’ long-term use of home-based e-SRS behavior patterns, in order to develop personalized interventions to support cancer patients’ symptom self-management and self-reporting for optimal health outcomes.