Pilot implementation to assess the feasibility and care team impact of an app-based interactive care plan to remotely monitor breast cancer survivors.

Autor: Stan DL; General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Inselman JW; Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Ridgeway JL; Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Johnson KN; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Christopherson LA; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., McColley SM; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Brown JK; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Phillips SA; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Allen SV; Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Hazelton JK; General Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Ruddy KJ; Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA., Haddad TC; Center for Digital Health, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. haddad.tufia@mayo.edu.; Medical Oncology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. haddad.tufia@mayo.edu.
Jazyk: angličtina
Zdroj: Journal of cancer survivorship : research and practice [J Cancer Surviv] 2022 Feb; Vol. 16 (1), pp. 13-23. Date of Electronic Publication: 2022 Feb 02.
DOI: 10.1007/s11764-021-01136-1
Abstrakt: Purpose: To assess the feasibility of an app-based, electronic health record (EHR)-integrated, interactive care plan (ICP) for breast cancer (BC) survivors.
Methods: A single-arm pilot study was conducted with female BC survivors. ICP tasks included quarterly quality of life (QOL) questionnaire; monthly assessments of fatigue, insomnia, sexual dysfunction, hot flashes, and recurrence symptoms; and daily activity reminders. Embedded decision trees escalated recurrence symptoms to providers. On-demand education was available for self-management of treatment-related toxicities. The primary objective was to assess patients' engagement with ICP tasks against feasibility thresholds of 75% completion rate. Secondary objectives were evaluation of the system's functionality to track and escalate symptoms appropriately, and care team impact measured by volume of escalation messages generated. We report preliminary results 6 months after the last patient enrolled.
Results: Twenty-three patients enrolled August to November 2020. Mean age was 50.1 years. All patients engaged with at least one ICP task. The monthly average task completion rates were 62% for the QOL questionnaire, 59% for symptom assessments, and 37% for activity reminders. Task completion rate decreased over time. Eleven of 253 symptoms and QOL questionnaires (4.3%) generated messages for care escalation.
Conclusion: Implementation of an app-based, EHR-integrated ICP in BC survivors was feasible and created minimal provider burden; however, patient engagement was below the feasibility threshold suggesting that changes may enhance broad implementation and adoption.
Implications for Cancer Survivors: An ICP may facilitate remote monitoring, symptom control, and recurrence surveillance for cancer survivors as strategies to enhance patient engagement are applied.
(© 2021. The Author(s).)
Databáze: MEDLINE
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