JMIR Publications

ABSTRACT

Background:

Using an iterative user-centered design process, our team developed a patient-centered adaptive supportive care system, PatientCareAnywhere, that provides comprehensive biopsychosocial screening and supportive cancer care to patients across the continuum of care adaptively. The overarching goal of PatientCareAnywhere is to improve cancer patients’ outcomes and self-efficacy by empowering patients with self-management skills and bringing cancer care support directly to them at home. Such support is adaptive to the patient’s needs and health status and coordinated across multiple sources in the forms of referrals, education, engagement of community resources, and secure social communication.

Objective:

This study included two phases. The objectives were to: 1) assess the usability of the new web-based PatientCareAnywhere system and 2) examine the preliminary efficacy of PatientCareAnywhere to improve patient-reported outcomes compared to usual care.

Methods:

For Phase I, usability testing participants included cancer patients (N=4) and caregivers (N=7) who evaluated the software prototype and provided qualitative (e.g., interviews) and quantitative (e.g., System Usability Scale [SUS]) feedback. For Phase II, participants in the 3-month pilot randomized control trial (RCT) were randomized to receive the PatientCareAnywhere intervention (N=36) or usual care control condition (N=36). Health-related quality of life (HRQOL) and cancer-relevant self-efficacy were assessed at baseline (pre-intervention) and post-intervention (12 weeks post-baseline); mean differences (Mdiff) between pre- and post-intervention scores were compared between the two groups.

Results:

Participants were highly satisfied with the prototype and reported above-average acceptable usability, with a mean SUS score of 84.09 (SD=10.02). Qualitative data supported the overall usability and perceived usefulness of the intervention, with a few design features (e.g., “help request” function) added based on participant feedback. In regards to the RCT, patients in the intervention group reported significant improvements in HRQOL from pre- to post-intervention (Mdiff=6.08 [SD=15.26]) compared with the control group (Mdiff=-2.95 [SD=10.63]; P=.01). In contrast, there was no significant between-group difference in self-efficacy (P=.09).

Conclusions:

Overall, PatientCareAnywhere represents a user-friendly, functional, and acceptable supportive care intervention with preliminary efficacy to improve HRQOL among patients diagnosed with cancer. Future studies are needed to further establish the efficacy of PatientCareAnywhere, as well as explore strategies to enhance user engagement and investigate the optimal intensity, frequency, and usage of the intervention to improve patient outcomes. Clinical Trial: ClinicalTrials.gov NCT02408406