Feasibility of implementing a text-based symptom-monitoring program of endometrial, ovarian, and breast cancer patients during treatment

Qual Life Res. 2021 Nov;30(11):3241-3254. doi: 10.1007/s11136-020-02660-w. Epub 2020 Oct 14.

Abstract

Purpose: To evaluate the feasibility of implementing systematic patient symptom monitoring during treatment using a smartphone.

Methods: Endometrial [n = 50], ovarian [n = 70] and breast [n = 193] cancer patients participated in text-based symptom reporting for up to 12 months. In order to promote equity, patients without a smartphone were provided with a device, with the phone charges paid by program funds. Each month, patients completed the Patient Health Questionnaire (PHQ-9), and 4 single items assessing fatigue, sleep quality, pain, and global quality of life during the past 7 days rated on a 0 (low) -10 (high) scale. Patients' responses were captured using REDCap, with oncologists receiving monthly feedback. Lay navigators provided assistance to patients with non-medical needs.

Results: Patients utilizing this voluntary program had an overall mean age of 60.5 (range 26-87), and 85% were non-Hispanic white. iPhones were provided to 42 patients, and navigation services were used by 69 patients. Average adherence with monthly surveys ranged between 75-77%, with breast patients having lower adherence after 5 months. The most commonly reported symptoms across cancer types were moderate levels (scores of 4-7) of fatigue and sleep disturbance. At 6 months, 71-77% of all patients believed the surveys were useful to them and their health care team.

Conclusions: We established the feasibility of initiating and managing patients in a monthly text-based symptom-monitoring program. The provision of smartphones and patient navigation were unique and vital components of this program.

Keywords: Breast cancer; Endometrial cancer; Ovarian cancer; Smartphones; Symptom assessment; Text-based monitoring.

MeSH terms

  • Breast Neoplasms* / therapy
  • Fatigue
  • Feasibility Studies
  • Female
  • Humans
  • Middle Aged
  • Quality of Life / psychology
  • Surveys and Questionnaires