JMIR Publications

ABSTRACT

Background:

Cardiotoxicity is a limitation of several cancer therapies, and early recognition improves outcomes. Symptom-tracking mHealth apps are feasible and beneficial, but key elements for mHealth symptom-tracking to indicate early signs of cardiotoxicity are unknown.

Objective:

We explored design, development, and implementation into a large academic medical center of a symptom-tracking app for early recognition of cardiotoxicity after cancer therapy initiation.

Methods:

We conducted a needs assessment via semi-structured interviews of >50% of the providers (oncologists, cardio-oncologists, radiation oncologists) who manage cancer treatment-related cardiotoxicity in the participating institution (n = 11), and interviews/co-design with 6 patients. Data were coded and analyzed using thematic analysis.

Results:

Providers indicated that there was no existing process to enable early recognition of cardiotoxicity and felt the app could reduce delays in diagnosis and lead to better patient outcomes. Signs and symptoms providers recommended for tracking included chest pain/tightness, shortness of breath, heart racing/palpitations, syncope, lightheadedness, edema, and excessive fatigue. Implementation barriers included determining who would receive symptom reports, ensuring all members of the patient’s care team (e.g., oncologist, cardiologist, primary care) were on the same page, and how to best integrate the app data into the EHR. Patients agreed that the app would be useful for enhanced symptom capture and education, and indicated willingness to use it.

Conclusions:

Providers and patients agree that a patient-facing, cancer treatment-related cardiotoxicity symptom-tracking mHealth app would be beneficial. Additional studies evaluating the role of mHealth as a potential strategy for targeted early cardioprotective therapy initiation are needed.