A systematic review of m-health apps on managing side effects of breast cancer treatment

The effect of an interactive nurse support program developed with a mobile application on patient outcomes in breast cancer patients who received outpatient chemotherapy: A randomized controlled trial

PURPOSE

To determine the effect of the interactive nurse support program developed with a mobile application on patient outcomes (symptom management, quality of life, perception of social support, anxiety) in breast cancer patients who received outpatient chemotherapy.

METHODS

The randomized controlled study was conducted in the outpatient chemotherapy unit of a public hospital between 2021 and 2023. The study sample consisted of 100 breast cancer patients receiving anthracycline-cyclophoshamide chemotherapy. Patients in the control group received standard care, and patients in the intervention group were applied an interactive nurse support program developed with a mobile application throughout four chemotherapy cycles. Memorial Symptom Assessment Scale (MSAS), EORTC QLQ-C30, EORTC QLQ-BR23 Scales, Multidimensional Perceived Social Support Scale (MPSSS), Beck Anxiety Scale (BAS) were used in data collection. Data were collected five times, including before chemotherapy (t0) and at the end of the first week after each chemotherapy (t1, t2, t3, t4).

RESULTS

MSAS, BAS total scores, EORTC QLQ-C30 and EORTC QLQ-BR23 Scales "Symptom Dimension" scores of the patients in the intervention group were found to be significantly lower than the control group at t1, t2, t3, t4 (p˂0.05). EORTC QLQ-C30 Scale "General Well-Being", "Functional Status", EORTC QLQ-BR23 "Functional Status" scores, MPSSS total scores of the patients in the intervention group were found to be significantly higher than the control group at t1, t2, t3, t4 measurements (p˂0.05).

CONCLUSIONS

The interactive nurse support program developed with the mobile application is effective on patient outcomes in breast cancer patients who received outpatient chemotherapy.

TRIAL REGISTRATION

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CLINICALTRIALS

gov, NCT05739175.

e-Health applications for outpatient professional pharmaceutical care services: A scoping review

Background

eHealth, or electronic or digital health, integrates information and communication technologies (ICT) into healthcare, including professional pharmaceutical care services. Nevertheless, to date, there is a lack of guidance in establishing the technologies' requirements, design, and implementation. Therefore, it urges the need to conduct a study regarding this topic is needed.

Objectives

To identify and map information regarding the functionalities, contents, and structures of e-health applications designed for professional pharmaceutical care services in outpatient settings and to explore their effectiveness, usability, and user-friendliness.

Methods

A scoping systematic review was conducted on the PubMed/Medline and Scielo databases, following the PRISMAScR guidelines. The study covered articles published between May 2018 and December 2023. The main search terms were "pharmaceutical care, dispensation, adverse drug reaction, mobile phone, app." Other related terms were also included.

Results

1469 articles were identified, of which different exclusion criteria excluded 1409. Sixty full-text articles were reviewed, of which six contained relevant information about the characteristics and functionalities of software designed to support pharmaceutical care activities, such as dispensation, pharmacovigilance, health education, and pharmacotherapeutic follow-up. In addition, one reference was identified in the selected articles, which was deemed relevant to the study. The characteristics and structures in mobile applications include medication information, identification of adverse drug reactions, pharmacist follow-up, indicators of safety and effectiveness, and interaction of patients with health care personnel, among others. In addition, two applications reported the effectiveness evaluation, whereas four showed results about usability tests.

Conclusions

This review retrieved six applications for outpatient professional pharmaceutical care services. Most of them are directed to the patients, and the most relevant functionalities were general information about medication and reminders, identification of interactions and adverse drug reactions, and adherence, among others. Two of six apps tested the effectivity, four tested usability, and three of six performed UCD, mainly using surveys. This review highlights the scarce information about implementing ICT in outpatient pharmaceutical care services.

A fusion architecture to deliver multipurpose mobile health services

Mobile Health (mHealth) services typically make use of customized software architectures, leading to development-dependent fragmentation. Nevertheless, irrespective of their specific purpose, most mHealth services share common functionalities, where standard pieces could be reused or adapted to expedite service deployment and even extend the follow-up of appearing conditions under the same service. To harness compatibility and reuse, this article presents a data fusion architecture proposing a common design framework for mHealth services. An exhaustive mapping of mHealth functionalities identified in the literature serves as starting point. The architecture is then conceptualized making use of the Joint Directors of Laboratories (JDL) data fusion model. The aim of the architecture is to exploit the multi-source data acquisition capabilities supported by smartphones and Internet of Things devices, and artificial intelligence-enabled feature fusion. A series of interconnected fusion layers ensure streamlined data management; each layer is composed of microservices which may be implemented or omitted depending on the specific goals of the healthcare service. Moreover, the architecture considers essential features related to authentication mechanisms, data sharing protocols, practitioner-patient communication, context-based notifications and tailored visualization interfaces. The effectiveness of the architecture is underscored by its instantiation for four real cases, encompassing risk assessment for youth with mental health issues, remote monitoring for SARS-CoV-2 patients, liquid intake control for kidney disease patients, and peritoneal dialysis treatment support. This breadth of applications exemplifies how the architecture can effectively serve as a guidance framework to accelerate the design of mHealth services.

Cocreating an Automated mHealth Apps Systematic Review Process With Generative AI: Design Science Research Approach

BACKGROUND

The use of mobile devices for delivering health-related services (mobile health [mHealth]) has rapidly increased, leading to a demand for summarizing the state of the art and practice through systematic reviews. However, the systematic review process is a resource-intensive and time-consuming process. Generative artificial intelligence (AI) has emerged as a potential solution to automate tedious tasks.

OBJECTIVE

This study aimed to explore the feasibility of using generative AI tools to automate time-consuming and resource-intensive tasks in a systematic review process and assess the scope and limitations of using such tools.

METHODS

We used the design science research methodology. The solution proposed is to use cocreation with a generative AI, such as ChatGPT, to produce software code that automates the process of conducting systematic reviews.

RESULTS

A triggering prompt was generated, and assistance from the generative AI was used to guide the steps toward developing, executing, and debugging a Python script. Errors in code were solved through conversational exchange with ChatGPT, and a tentative script was created. The code pulled the mHealth solutions from the Google Play Store and searched their descriptions for keywords that hinted toward evidence base. The results were exported to a CSV file, which was compared to the initial outputs of other similar systematic review processes.

CONCLUSIONS

This study demonstrates the potential of using generative AI to automate the time-consuming process of conducting systematic reviews of mHealth apps. This approach could be particularly useful for researchers with limited coding skills. However, the study has limitations related to the design science research methodology, subjectivity bias, and the quality of the search results used to train the language model.

Assessing the Quality, Privacy, and Security of Breast Cancer Apps for Arabic Speakers: Systematic Search and Review of Smartphone Apps

BACKGROUND

Breast cancer is a widespread disease, and its incidence is rapidly increasing in the Middle East and North Africa region. With the increasing availability of smartphone apps for various health purposes, breast cancer apps have emerged as tools for raising awareness, providing support, and empowering women affected by this disease. These apps offer many features, including information on breast cancer risk factors, self-examination guides, appointment reminders, and community support groups or hotlines. Using apps raises the risk of privacy and security issues, and we hope that examining these features of the apps will contribute to the understanding of how technology can be used to improve these apps and provide insights for future development and improvement of breast cancer apps.

OBJECTIVE

This study aims to critically review the quality, privacy, and security of breast cancer apps available to Arabic speakers.

METHODS

Similar to several recent studies, we used a systematic search for apps available in Google Play and Apple App stores using both the web interface and the built-in native stores installed on smartphones. The search was conducted in mid-December 2022 in Arabic using the following keywords: سرطان الثدي - فحص سرطان الثدي - علاج سرطان الثدي - مرض سرطان الثدي - أعراض سرطان الثدي - فحص الثدي (breast cancer, breast cancer treatment, breast cancer disease, breast cancer symptoms, breast cancer screening, and breast test). These preidentified search terms are based on earlier work concerning the top searched breast cancer topics by Arabic speakers through Google's search engine. We excluded apps that did not have an Arabic interface, were developed for non-Arabic speakers, were paid, needed a subscription, or were directed toward health care workers. The Mobile App Rating Scale was used to evaluate the quality of the apps concerning their engagement, functionality, aesthetics, and information. A risk score was calculated for the apps to determine their security risk factors.

RESULTS

Only 9 apps were included, with most (6/9, 67%) being supported by advertisements and categorized as informational. Overall, the apps had low numbers of downloads (>10 to >1000). The majority of the included apps (8/9, 89%) requested dangerous access permissions, including access to storage, media files, and the camera. The average security score of the included apps was 3.22, while only 2 apps provided information about data security and privacy. The included apps achieved an overall average quality score of 3.27, with individual dimension scores of 4.75 for functionality, 3.04 for information, 3.00 for aesthetics, and 2.32 for engagement.

CONCLUSIONS

The limited availability of breast cancer apps available to Arabic speakers should be a call to action and prompt health care organizations and developers to join forces and collaboratively develop information-rich, usable, functional, engaging, and secure apps.

Decoding the molecular mechanism of stypoldione against breast cancer through network pharmacology and experimental validation

Breast cancer is the primary factor contributing to female mortality worldwide. The incidence has overtaken lung cancer. It is the most difficult illness due to its heterogeneity and is made up of several subtypes, including Luminal A and B, basal-like, Her-2 overexpressed and TNBC. Amongst different breast carcinoma subtypes, TNBC is the most deadly breast cancer subtype. The hostile nature of TNBC is mainly attributed to its lack of three hormonal receptors and hence lack of targeted therapy. Furthermore, the current diagnostic options like radiotherapy, surgery and chemotherapy render unsuccessful due to recurrence, treatment side effects and drug resistance. The majority of anticancer drugs come from natural sources or is developed from them, making nature a significant source of many medicines. Marine-based constituents such as nucleotides, proteins, peptides, and amides are receiving a lot of interest in the field of cancer treatment due to their bioactive properties. The role of stypoldione in this study as a prospective treatment for breast carcinoma was examined, and we sought to comprehend the molecular means/pathways this chemical employs in breast carcinoma. The most promising possibility for an anti-cancer treatment is stypoldione, a marine chemical produced from the brown alga Stypopodium zonale. We investigated stypoldione's mode of action in breast cancer using the network pharmacology method, and we confirmed our research by using a number of computational tools, including UALCAN, cBioportal, TIMER, docking, and simulation. The findings revealed 92 common targets between the chemical and breast cancer target network. Additionally, we found that stypoldione targets a number of unregulated genes in breast cancer, including: ESR1, HSP90AA1, CXCL8, PTGS2, APP, MDM2, JAK2, KDR, LCK, GRM5, MAPK14, KIT, and several signaling pathways such as FOXO signaling pathway, VEGF pathway, calcium signaling pathway, MAPK/ERK pathway and Neuroactive ligand-receptor interaction. The examined medication demonstrated a strong affinity for the major targets, according to a docking analysis. The best hit compound produced a stable protein-ligand pair, as predicted by molecular dynamics simulations. Our results are supported by the fact that when in-vitro assays were done on melanoma using stypoldione compound it was found that its mechanisms of action involved the PI3K/mTOR/Akt and NF-kB pathways. This study was set out to inspect the possible value of stypoldione as a breast cancer cure and to get a deeper understanding of the molecular mechanisms by which this drug acts on breast cancer.

Effects of social support and self-efficacy on eHealth literacy in Korean women undergoing breast cancer treatment: A secondary analysis

Objective

Patients with breast cancer need to seek out and understand relevant health information to make informed decisions about long-term and complicated illnesses. With the increased use of interventions using online health information, research on eHealth literacy should be expanded. However, existing studies on the factors affecting eHealth literacy in patients with breast cancer are currently lacking. This study, therefore, conducts a secondary analysis of a previous study that surveyed the quality of life of patients with breast cancer. The primary study found a significant correlation between eHealth literacy, social support, and self-efficacy. In this secondary analysis study, we specifically examine eHealth literacy among patients with breast cancer undergoing treatment, and how patient demographic characteristics, breast cancer-specific self-efficacy, and social support contribute to their eHealth literacy.

Methods

A total of 143 women receiving outpatient treatment or were hospitalized for breast cancer at a cancer hospital in South Korea participated in the study from January to November 2022. The eHealth Literacy Scale (eHEALS), Multidimensional Social Support Scale, and Breast Cancer Survivors Scale were utilized in the analysis. The data were analyzed using a multiple regression analysis.

Results

Full-time employment (β ​= ​0.19, P ​= ​0.006), a monthly family income of over 4 million won (3600 USD) (β ​= ​0.14, P ​= ​0.042), completing a high school education (β ​= ​0.52, P ​< ​0.001), completing college level or higher education (β ​= ​0.54, P ​< ​0.001), age (β ​= ​-0.23, P ​= ​0.003), and social support (β ​= ​0.21, P ​= ​0.002) were predictors of eHealth literacy, explaining 40.2% of the total variance (F ​= ​14.63, P ​< ​0.001).

Conclusions

Social support was identified as a new factor influencing eHealth literacy among patients with breast cancer undergoing treatment. Therefore, nursing interventions to strengthen social support should be developed to improve eHealth literacy.