Adherence to Oral Chemotherapy Regimens May Improve With Assistance From Smartphone Mobile Apps

Oral chemotherapy (OC)–regimen adherence may see a boost if patient monitoring is performed by a smartphone mobile app, according to a virtual poster presentation at the Oncology Nursing Society’s 46th Annual Congress.

“Studies show that mobile monitoring of cancer patients can be effective, may reduce chemotherapy-related toxicity, and helps maintain maximum dose intensity,” Erin Fusco, DNP, FNP-BC, MSN, OCN, RN, BSN, an associate professor of nursing at Quinnipiac University School of Nursing, said during the presentation, noting that the utility of apps also includes the added communication with providers and nurses.

“[An app] saves us time from having to take time off from the medication, and dose appropriately when the patient is showing a toxicity of concern. It gives us a moment to either hold the dose or lower the dose for a time period until the toxicity is noted,” Fusco said during the presentation.

The app includes medication instructions; the ability to input onset and intensity of therapy-related toxicities or symptoms; visual aids to help patients determine the grade of toxicity; and a mobile oncological diary showing a patient’s prescribed therapy, self-assessed symptoms and general data. A web dashboard then allows health professionals to check data and monitor the patients. There’s also a built-in alarm model that alerts clinicians of critical condition — giving them time to respond in a timelier manner. A feedback loop is also included so that patients can tell developers what does and doesn’t work for them.

For patients, OC allows for more self-control and fewer hospital visits, but also comes along with the burden of having to manage the chemotherapy on their own, as well as monitor side effects. Other major burdens include having to integrate pills into everyday life, watching and waiting when side effects occur, whether or not the patient has family support, pills dominating daily life scheduling and the possibility of experiencing a life-threatening condition. These are all to be considered when it comes to designing a smartphone app.

Roadblocks that come along for patients who take OC include having to be assessed by the clinician for barriers (socioeconomic, physical, psychological or regulatory) that could affect adherence, and the fact that many patients believe that taking a pill is less harmful than undergoing intravenous chemotherapy, which is not true, Fusco said.

One of the most important steps, according to Fusco, is to train the staff on the app so that they are able to efficiently educate the patient — giving them more empowerment and a sense of self-control. “Education should include storage, handling, preparation, administration and disposal of oral chemotherapy, as well as supportive care medications and measures, drug and food interactions and a plan for missed doses,” she said during the presentation.

Overall, Fusco said that there is a need for more apps that are specifically designed for oncology patients. “This alone could encourage patient self-efficacy adherence and personalization of care,” she said during the presentation. Fusco noted that further studies should be conducted to research the efficacy in adherence.

Reference

Fusco E. Is There an App for That? An Integrative Review of the Use of Smartphone Mobile Apps for Patients Taking Oral Chemotherapy. Presented at: the Oncology Nursing Society 46th Annual Congress. April 20, 22, 27, 29, 2021.