JMIR Publications

ABSTRACT

Background:

Although the introduction of oral anti-cancer therapies has at least in part shifted treatment from clinician-supervised hospital care to patient-managed home regimens, breast cancer patients receiving oral CDK4/6 inhibitor (CDK4/6i) therapy still require regular hospital visits to monitor side effects. Telemonitoring has the potential to reduce hospital visits, while maintaining quality care.

Objective:

We aimed to develop a digital home-based health care system (DHHC) for the acquisition of electrocardiograms (ECG), white blood cell (WBC) counts, side effect photo documentation and patients’ quality of life (QoL).

Methods:

The DHHC was set up with an Apple Watch Series 6 (ECG measurements), HemoCue WBC DIFF Analyser (WBC counts), iPhone SE (QoL and photo documentation), mobile Wi-Fi router TP-Link M7350-4G and Raspberry Pi 4 Model B. A custom-build app stored and synchronized remotely collected data with the clinic. DHHC feasibility and acceptance by patients was evaluated in a prospective mono-centric study.

Results:

76 breast cancer patients under CDK4/6i therapy received the DHHC. Overall, 61% of patients felt good about self-monitoring and 79% indicated willingness to integrate remote monitoring in their future cancer care. Significant reduction of neutrophile count under CDK4/6i therapy could be successfully detected via home-based, patient-centric measurement.

Conclusions:

Comprehensive remote side effect monitoring appears feasible and shows clinical potential. Integration of the DHHC into the routine care could enable continuous and accurate monitoring of side effects, reduce the frequency of hospital visits, and improve patient satisfaction. Further studies are necessary to optimize the system and evaluate its long-term and socioeconomic benefits.