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Yunis R, Fonda SJ, Aghaee S, Kubo A, Davis SW, Liu R, Neeman E, Oakley-Girvan I. Mobile app activity engagement by cancer patients and their caregivers informs remote monitoring. Sci Rep 2024; 14:3375. [PMID: 38336943 PMCID: PMC10858186 DOI: 10.1038/s41598-024-53373-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
Mobile phone applications ("apps") are potentially an effective, low-burden method to collect patient-reported outcomes outside the clinical setting. Using such apps consistently and in a timely way is critical for complete and accurate data capture, but no studies of concurrent reporting by cancer patient-caregiver dyads have been published in the peer-reviewed literature. This study assessed app engagement, defined as adherence, timing, and attrition with two smartphone applications, one for adult cancer patients and one for their informal caregivers. This was a single-arm, pilot study in which adult cancer patients undergoing IV chemotherapy or immunotherapy used the DigiBioMarC app, and their caregivers used the TOGETHERCare app, for approximately one month to report weekly on the patients' symptoms and wellbeing. Using app timestamp metadata, we assessed user adherence, overall and by participant characteristics. Fifty patient-caregiver dyads completed the study. Within the one-month study period, both adult cancer patients and their informal caregivers were highly adherent, with app activity completion at 86% for cancer patients and 84% for caregivers. Caregivers completed 86% of symptom reports, while cancer patients completed 89% of symptom reports. Cancer patients and their caregivers completed most activities within 48 h of availability on the app. These results suggest that the DigiBioMarC and TOGETHERCare apps can be used to collect patient- and caregiver-reported outcomes data during intensive treatment. From our research, we conclude that metadata from mobile apps can be used to inform clinical teams about study participants' engagement and wellbeing outside the clinical setting.
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Affiliation(s)
- Reem Yunis
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA
| | | | - Sara Aghaee
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Ai Kubo
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sharon W Davis
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA
| | - Raymond Liu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
- Department of Hematology Oncology, Kaiser Permanente Northern California, San Francisco, CA, USA
| | - Elad Neeman
- San Rafael Medical Center, Kaiser Permanente Northern California, San Rafael, CA, USA
| | - Ingrid Oakley-Girvan
- Strategy and Science Departments, Medable Inc., 525 University Avenue, Suite A70, Palo Alto, CA, 94301, USA.
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Shi N, Ching Wong AK, Yuet Wong FK, Zhang N, Zhu W, Shen K, Lai X, Jin Y, Gu C, Nie L, Dong X. Feasibility of a mobile health app-based self-management program for Chinese patients with breast cancer receiving chemotherapy: A randomized controlled pilot study. Digit Health 2024; 10:20552076241231560. [PMID: 38410790 PMCID: PMC10896051 DOI: 10.1177/20552076241231560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Objective There are currently an increasing number of mobile health (mHealth) programs offered to patients with breast cancer undergoing chemotherapy, but their rate of adherence to app usage has remained low. This study aimed to examine the feasibility of an mHealth app-based program such as the adherence rate of app usage and determine the preliminary effects on self-efficacy, quality of life, symptom burden and healthcare utilization in these patients. Methods We conducted a randomized controlled pilot trial. Ninety-six participants were randomly allocated into either an intervention group or a control group (routine care plus a placebo app). The intervention group engaged in a 6-week self-regulation activity and received nurse-led social support via the app. The intention-to-treat principle was adopted. The generalized estimating equation was utilized to analyze the between-group, within-group and interaction effectiveness of this program. Results Totally 96 participants were enrolled from 16 May to 23 August 2022. The average rate of adherence to app usage increased from 4.8% at week 3 to 51.2% at week 6. There was a statistically significant reduction in the physiological efficacy scores of the intervention (p < .001) and control groups (p < .001) at week 6, compared with the baseline. At week 6, the intervention group reported a significantly lower symptom burden (p = .042) and significantly better physical well-being than the control group (p = .024). Conclusions It is feasible to perform an mHealth app-based self-management program for patients with breast cancer receiving chemotherapy. Nurses can utilize this program to facilitate patient self-management of symptoms during chemotherapy. Registration Clinicaltrials.gov, https://clinicaltrials.gov, (NCT05192525).
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Affiliation(s)
- Nuo Shi
- School of Nursing, Dalian Medical University, Dalian, China
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | | | | | - Nan Zhang
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Weiyi Zhu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kunwei Shen
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaobin Lai
- School of Nursing, Fudan University, Shanghai, China
| | - Yufei Jin
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengjia Gu
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lijing Nie
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaojing Dong
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Donkor A, Ayitey JA, Adotey PN, Ofori EO, Kitson-Mills D, Vanderpuye V, Opoku SY, Luckett T, Agar MR, Engel-Hills P. Mobile-Based Application Interventions to Enhance Cancer Control and Care in Low- and Middle-Income Countries: A Systematic Review. Int J Public Health 2023; 68:1606413. [PMID: 38125709 PMCID: PMC10732306 DOI: 10.3389/ijph.2023.1606413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Objective: To identify and appraise mobile-based application (mAPP) interventions that have been used to support cancer control and care in low- and middle-income countries (LMICs). Methods: Four electronic databases were systematically searched for studies that reported primary research findings related to mAPP interventions applied in oncology settings in LMICs. A narrative synthesis was performed using the Mhealth Index and Navigation Database as an analytical framework. Results: Twenty studies reporting 18 cancer control and care mAPPs were included in this review. Among these mAPPs, ten focused on prevention, screening and early detection of cancer, five provided information to optimise supportive and palliative care, two provided support to assist treatment-shared decision-making and one covered information for follow-up and survivorship care. Conclusion: Cancer mAPP interventions are gradually gaining attention in LMICs as they provide unique resources for empowering and strengthening the role of people with cancer in their own care. To enhance cancer control, a focus on prevention and early detection is important; however, more mAPP interventions related to cancer treatment, follow-up and survivorship are also needed to enable more cost-effective cancer care.
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Affiliation(s)
- Andrew Donkor
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Jennifer Akyen Ayitey
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Prince Nyansah Adotey
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Esther Oparebea Ofori
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Doris Kitson-Mills
- Department of Medical Imaging, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | | | - Tim Luckett
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Meera R. Agar
- Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Penelope Engel-Hills
- Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
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Musa HS, Krichen M, Altun AA, Ammi M. Survey on Blockchain-Based Data Storage Security for Android Mobile Applications. SENSORS (BASEL, SWITZERLAND) 2023; 23:8749. [PMID: 37960449 PMCID: PMC10650731 DOI: 10.3390/s23218749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 10/19/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023]
Abstract
This research paper investigates the integration of blockchain technology to enhance the security of Android mobile app data storage. Blockchain holds the potential to significantly improve data security and reliability, yet faces notable challenges such as scalability, performance, cost, and complexity. In this study, we begin by providing a thorough review of prior research and identifying critical research gaps in the field. Android's dominant position in the mobile market justifies our focus on this platform. Additionally, we delve into the historical evolution of blockchain and its relevance to modern mobile app security in a dedicated section. Our examination of encryption techniques and the effectiveness of blockchain in securing mobile app data storage yields important insights. We discuss the advantages of blockchain over traditional encryption methods and their practical implications. The central contribution of this paper is the Blockchain-based Secure Android Data Storage (BSADS) framework, now consisting of six comprehensive layers. We address challenges related to data storage costs, scalability, performance, and mobile-specific constraints, proposing technical optimization strategies to overcome these obstacles effectively. To maintain transparency and provide a holistic perspective, we acknowledge the limitations of our study. Furthermore, we outline future directions, stressing the importance of leveraging lightweight nodes, tackling scalability issues, integrating emerging technologies, and enhancing user experiences while adhering to regulatory requirements.
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Affiliation(s)
- Hussam Saeed Musa
- Faculty of Technology, Department of Computer Engineering, Selçuk University, 42130 Konya, Turkey; (H.S.M.); (A.A.A.)
| | - Moez Krichen
- Faculty of Computer Science and Information Technology, Al-Baha University, Al Baha 65431, Saudi Arabia
- ReDCAD Laboratory, National School of Engineers of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Adem Alpaslan Altun
- Faculty of Technology, Department of Computer Engineering, Selçuk University, 42130 Konya, Turkey; (H.S.M.); (A.A.A.)
| | - Meryem Ammi
- Digital Forensics Department, Criminal Justice College, Naif Arab University for Security Sciences, Riyadh 14812, Saudi Arabia;
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Suchodolska G, Koelmer A, Puchowska M, Senkus E. Are All Societies Ready for Digital Tools? Feasibility Study on the Use of Mobile Application in Polish Early Breast Cancer Patients Treated with Perioperative Chemotherapy. Healthcare (Basel) 2023; 11:2114. [PMID: 37510555 PMCID: PMC10379019 DOI: 10.3390/healthcare11142114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/12/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The population of individuals affected by breast cancer is growing, and with advances in cancer treatment implemented into usual care, there is an urgent need to improve the recognition, monitoring and treatment of therapy-induced adverse effects. This study aims to explore the use of an in-app electronic questionnaire to assess and monitor chemotherapy-related symptoms in early breast cancer patients treated with perioperative chemotherapy. METHOD Between December 2019 and June 2021, 72 female study participants used the mobile app Centrum Chorób Piersi UCK and completed an in-app questionnaire about the 14 most common chemotherapy-related symptoms. Replies including symptoms with a critical value triggered automatic email alerts to the nursing team. RESULTS Acceptance of the study was higher among younger women and patients originating from rural areas, while possible digital exclusion among patients >60 years was observed during the enrolment process. A total of 55 participants completed the electronic questionnaire at least once and generated 553 responses with 1808 specific problems reported. Fatigue (n = 428) was the most common problem, and fever (n = 5) the least reported problem. A total of 21 participants triggered alerts with responses containing symptoms with critical value assessment (n = 89). Significant negative correlation was observed between the number of responses and time from the first chemotherapy administration; however, the number of responses was not determined by any sociodemographic or medical factors. Significant positive correlations were identified between the number of communicated problems and participants' age. The usage of our electronic symptom assessment questionnaire decreased substantially after the period of active encouragement during the study enrolment. CONCLUSIONS Not all societies are ready for innovative eHealth solutions. Patients' age should be carefully considered when app-based interventions are introduced to usual cancer care. Additional support is suggested for older patients to improve their awareness and participation in eHealth interventions. More research involving older participants is needed to explore and address their particular needs and perspectives on eHealth solutions.
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Affiliation(s)
- Grażyna Suchodolska
- Department of Oncology & Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland
| | - Anna Koelmer
- Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdańsk, Dębinki 1, 80-211 Gdańsk, Poland
| | - Monika Puchowska
- Department of Non-Commercial Clinical Research, Clinical Research Support Centre, Medical University of Gdańsk, Skłodowskiej-Curie 3a, 80-210 Gdańsk, Poland
| | - Elżbieta Senkus
- Department of Oncology & Radiotherapy, Faculty of Medicine, Medical University of Gdańsk, Smoluchowskiego 17, 80-214 Gdańsk, Poland
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Wanchai A, Anderson EA, Armer JM. A systematic review of m-health apps on managing side effects of breast cancer treatment. Support Care Cancer 2022; 31:86. [PMID: 36574048 DOI: 10.1007/s00520-022-07464-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/12/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE After breast cancer treatment, women with breast cancer may experience distress caused by treatment side effects, both in physical and psychological aspects. Technology use is increasing in favor among women. Therefore, it is essential to update the scientific evidence regarding mobile and web apps' effectiveness in managing the side effects of breast cancer treatments for breast cancer survivors. The purpose of this systematic review was to investigate the scientific evidence on the effectiveness of mobile and web apps in managing the side effects of breast cancer treatments among this group. METHODS A literature search was conducted using ScienceDirect, Scopus, PubMed, CINAHL, and Cochrane. Published papers in English focused on mobile and web apps and the side effects of breast cancer treatment in breast cancer survivors were selected. The search reviewed studies from January 2011 to December 2021. From a total of 925 retrieved manuscripts, 11 studies were included for analysis. RESULTS The findings showed that mobile apps were more frequently used and more likely to be an effective method for managing the side effects of breast cancer treatment among breast cancer survivors. The content in web or mobile apps for breast cancer survivors should include five categories: (1) information about cancer, (2) overview of cancer care, (3) opportunities for interaction with other people, (4) symptom management strategies, and (5) feedback about cancer treatment side effect management. However, a few studies examined the effects of a combination of mobile and web apps in managing breast cancer treatment side effects. Therefore, future research is needed to examine solo and combination use. In addition, more rigorous studies are warranted to examine these interventions. CONCLUSIONS Nurses may refer survivors to these resources to obtain more information and effectively manage the signs and symptoms of breast cancer and its treatment side effects.
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Affiliation(s)
- Ausanee Wanchai
- Boromarajonani College of Nursing Buddhachinaraj, Faculty of Nursing, Praboromarajchanok Institute, Phitsanulok, Thailand.
| | | | - Jane M Armer
- Sinclair School of Nursing, University of Missouri, Columbia, MO, 65211, USA.,American Lymphedema Framework Project, Columbia, MO, 65211, USA
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Obrero-Gaitán E, Cortés-Pérez I, Calet-Fernández T, García-López H, López Ruiz MDC, Osuna-Pérez MC. Digital and Interactive Health Interventions Minimize the Physical and Psychological Impact of Breast Cancer, Increasing Women's Quality of Life: A Systematic Review and Meta-Analysis. Cancers (Basel) 2022; 14:4133. [PMID: 36077670 PMCID: PMC9454975 DOI: 10.3390/cancers14174133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 12/24/2022] Open
Abstract
Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect of DIHIs on improving pain, anxiety, depression, quality of life (QoL), and upper extremity (UE) disability-related lymphedema in women with BC. METHODS We searched PubMed Medline, Web of Science, Scopus, CINAHL, Physiotherapy Evidence Database, and SciELO for the period ending February 2022. We included studies that assessed the effect of DIHIs on UE motor disability, pain, anxiety, depression, and QoL in women with BC. The effect size was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI). RESULTS Twenty studies providing data from 1613 women with BC were included. With respect to UE disability, DIHIs increased flexion (SMD, 1.92; 95%CI: -1.16, 2.68), abduction (SMD, 1.66; 95%CI: 0.91, 2.42), external rotation shoulder range of motion (SMD, 1.1; 95%CI: 0.36, 1.85), UE function (SMD, -0.72; 95%CI: -1.31, -0.13), and handgrip strength (SMD, 0.4; 95%CI: 0.21, 0.59). DIHIs reduced pain (SMD, -0.8; 95%CI: -1.31, -0.26), anxiety (SMD, -1.02; 95%CI: -1.71, -0.34), and depression (SMD, -1.57; 95%CI: -3.1, -0.08). Finally, DIHIs increased overall health (SMD, 0.6; 95%CI: 0.31, 0.89). CONCLUSIONS Right at the end of therapy, DIHIs are effective at improving UE function, pain, anxiety, depression, and QoL in women with BC. VRBT has a greater effect than SABT for the assessed outcomes.
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Affiliation(s)
- Esteban Obrero-Gaitán
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain
| | - Irene Cortés-Pérez
- Department of Health Sciences, University of Jaén, Campus Las Lagunillas s/n, 23071 Jaén, Spain
| | | | - Héctor García-López
- Physical Therapy and Medicine, Department of Nursing, University of Almeria, Road Sacramento s/n, 04120 Almeria, Spain
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