JMIR Publications

ABSTRACT

Background:

mHealth importance has been growing over time due to recent demographic and epidemiological trends and the rise of chronic conditions, enhanced smartphone hardware and software functionalities, and the need to contain healthcare spending. Yet, even when beneficial to improve patient outcomes, sustained mHealth app usage is not necessarily observed in clinical practice.

Objective:

This work aims at investigating barriers and enablers to continuous uptake of mHealth solutions to support the treatment stage within the continuum of cancer care.

Methods:

A scoping literature review has been conducted on MedLine and Web of Science databases in March 2022. Studies analyzing mHealth solutions for cancer patients under ongoing treatments were searched. Experimental study designs including RCTs, and observational studies were considered. Data on study characteristics, patient population, app functionalities, study outcomes, and implementation barriers and enablers were extracted. The Consolidated Framework for Implementation Research (CFIR) was used as a practical tool to guide data collection and analysis. Evidence was synthetized mostly with a narrative format.

Results:

Overall, 89 papers were included for data synthesis. Almost half of the studies (N=41, 46.1%) were published in Europe. The most frequent study design is RCT (N=26, 29.2%), but overall single-arm non-comparative studies (N=50, 56.2%) prevail. As for implementation barriers and enablers assessed using the CFIR, on one hand, involvement of several stakeholders in the app co-design, small scales pilot testing, and social endorsement by key opinion leaders are amongst the most relevant facilitators. On the other hand, individuals’ perceptions of smartphone use in certain social contexts (e.g., at work), a weak sense of identification with health service providers or the lack of interoperability with hospital IT systems are the most recurrent barriers.

Conclusions:

The hype surrounding mHealth diffusion is hindered by a number of barriers and facilitators that affect its implementation in the continuum of cancer care. These elements should be systematically considered in the attempt to close the “research-do gap” between what works in principle and what is used in clinical practice, hopefully leading to a sustained use of mHealth in real life. Clinical Trial: None.