- Email: [email protected]
Patient’s usability test results of a CINV diary application for smartphones
Annals of Oncology 30 (Supplement 5): v816–v821, 2019 doi:10.1093/annonc/mdz272
CANCER NURSING: DIGITAL INNOVATIONS IN HEALTH CN1
Patients’ usage and perception of an interactive app for symptom management and self-care during cancer treatment
Background: Employing apps in assessment of symptoms during cancer treatment facilitates detection of adverse events and may improve patient outcomes. Our interactive app Interaktor supports patients’ symptom management by regular symptom reporting, alerts for rapid access to staff in case of severe symptoms and continual access to relevant self-care advice. The aim of this study was to describe usage and explore perceptions of using Interaktor during cancer treatment. Methods: The study includes the participants from the intervention arms of two separate randomized controlled trials (RCT) on patients with breast cancer (n ¼ 74) during neoadjuvant chemotherapy and locally advanced prostate cancer (n ¼ 75) during radiotherapy. It comprises usage metrics analysed by descriptive statistics and interviews analyzed by conventional content analysis. Results: Adherence to daily reporting during treatment was in median above 80 %. Most patients viewed the information pages with self-care advice numerous times. The app was perceived user-friendly, faciliating interaction with health care professionals and supporting self care. Symptom reporting was a quick and comfortable way to access help. Using the app generated feelings of being monitored, involved and cared for. Further it supported attentiveness to and reflection of own well- being but could also serve as a reminder of illness. Some patients described that vigor, comorbidity, and cognitive side effects from the treatment influenced the motivation for and ability to symptom report. The information pages with self care advice were useful and appreciated and gave an idea of what was to be expected during treatment. Patients requested added and more comprehensive information on psychological symptoms and dietary advice. Conclusions: The Interaktor app is a userfriendly and convenient alternative for patients contact and involvement with health care that aided symptom management, self-care and further enhanced patients participation in their care. Clinical trial identification: NCT02479607 and NCT02477137. Legal entity responsible for the study: Karolinska Institutet. Funding: Swedish Cancer Foundation, Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare and Karolinska Institutet. Disclosure: All authors have declared no conflicts of interest.
Variables
Results (%)
Contents Navigation Graphic design Utility
81% 79% 83% 90%
*N ¼ 116 Oncology chemo patients level agreement 83% of patients consider this app useful for them and 86% believe it would help to improve CINV management. 94% of patients would recommend it to other patients.
Conclusions: The CINV app addresses main concerns for patients receiving chemotherapy such as the clinical situation and individual emetic risk of patient or complexity of the prescribed antiemetic regimen and impact of CINV in patients daily life. By soliciting feedback from oncology patients, we ensured that the app was acceptable and beneficial for them although some improvement points were suggested. Reporting of symptoms after CT enhances CINV management, self-care, and participation without being a burden to patients, indicating that app can be used in clinical practice by patients. Legal entity responsible for the study: Vifor Pharma Espa~ na SL. Funding: Vifor Pharma Espa~ na SL. Disclosure: P. Fernandez: Advisory / Consultancy, advisor activities: Vifor Pharma Espa~na. All other authors have declared no conflicts of interest.
CN3
Colorectal telephone assessment pathway (CTAP): A viable means of shortening time to a definitive diagnosis of colorectal cancer (CRC)
H. Watson GI Surgery / Colorectal, Guy’s and St. Thomas’ Hospital NHS Trust, London, UK CN2
Patient’s usability test results of a CINV diary application for smartphones 1
2
P. Fernandez , Y. Escobar Alvarez Lung Funtional Unit, Catalan Institute of Oncology, Hospital Duran i Reynals, non, Barcelona, Spain, 2Medical Oncology, Hospital General Universitario Gregorio Mara~ Madrid, Spain
1
Background: Chemotherapy-induced nausea and vomiting (CINV) continue to be a clinical problem, particularly in the delayed phase. CINV lack of control worsens the quality of life of patients and it is associated with complications increasing costs for healthcare services. CINV app is a free service addressed to patients treated with emetogenic chemotherapy (CT), empowering patients to report CINV impact in life and relevant information. This study aims to evaluate the usability and acceptability of a smartphone app to improve CINV management in patients receiving CT. Methods: We used 4-dimensions test (content, graphic design, navigation and clinical utility) to evaluate APP’s usability and acceptability. Clinical and technical researchers worked together to develop the app’s test. 44 oncology nurses of 33 representative Spanish hospitals were invited to participate (from 31st January to 5th April 2019) enrolling a total amount of 116 oncology patients for testing purposes. After using the app for a chemo cycle the patient was asked to fulfil an online usability test. Results: Described in the table.
Background: It is well documented that survival of CRC is dependent on early diagnosis. In England, the Department of Health’s cancer policy states that patients with symptoms of suspected cancer must be seen and assessed by the specialist team within 2 weeks of a referral by their General Practitioner (GP). The traditional 2 week wait (2ww) referral route involves these patients being seen in clinic within 2 weeks, where they are assessed and an investigation is booked, taking up to 4 weeks for first investigation and diagnosis. We have introduced a novel Straight to Test / CTAP for these patients, which rationalises the patient journey, ensuring that the patient has the right test first time, without delay. Methods: Our service is a Consultant Nurse led Straight to Test / CTAP. All 2ww patients referred by the GP with suspected CRC are assessed via the CTAP. Upon receipt of the electronic referral from their GP, a colorectal assessment is carried out via telephone within 48 hours of referral by the Consultant nurse or a member or her specialist nursing team. The patient is then triaged for the most appropriate investigation, according to a protocol, which is then booked within 2 weeks of the GPs referral. Results: The CTAP has been running now for 5 years with over 4000 patients being assessed via this route. In 2017 & 2018 the cancer yield from our service was 4% which matches that of traditional out-patient assessments routes. However we were able to reduce the patient pathway by 10 days by the introduction of the CTAP. 70% of patients had an endoscopy procedure as their first investigation and 28% had a radiological investigation (usually CT Colonography). 90% of patients had their diagnosis or given the all clear by day 14. Conclusions: This pathway has significantly shortened the patient’s pathway and time diagnosis for our patients, meaning that those patients with CRC are diagnosed by day 14. Patients with other pathologies are also diagnosed quicker and those patients with no serious pathology are reassured and discharged back to their GP We have managed to reduce waiting times from referral to diagnosis and to ensure all patients on the 2ww pathway have a more streamline patient focused experience, avoiding unnecessary hospital visits.
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz272.001/5577883 by guest on 24 October 2019
M-T. Crafoord, M. Fjell, M.I. Nilsson, M.I. Nilsson, K. Sundberg, A. Langius-Eklo¨f Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Table: CN2 Average of patients that agree for each dimension
CANCER NURSING: DIGITAL INNOVATIONS IN HEALTH CN1
Patients’ usage and perception of an interactive app for symptom management and self-care during cancer treatment
Background: Employing apps in assessment of symptoms during cancer treatment facilitates detection of adverse events and may improve patient outcomes. Our interactive app Interaktor supports patients’ symptom management by regular symptom reporting, alerts for rapid access to staff in case of severe symptoms and continual access to relevant self-care advice. The aim of this study was to describe usage and explore perceptions of using Interaktor during cancer treatment. Methods: The study includes the participants from the intervention arms of two separate randomized controlled trials (RCT) on patients with breast cancer (n ¼ 74) during neoadjuvant chemotherapy and locally advanced prostate cancer (n ¼ 75) during radiotherapy. It comprises usage metrics analysed by descriptive statistics and interviews analyzed by conventional content analysis. Results: Adherence to daily reporting during treatment was in median above 80 %. Most patients viewed the information pages with self-care advice numerous times. The app was perceived user-friendly, faciliating interaction with health care professionals and supporting self care. Symptom reporting was a quick and comfortable way to access help. Using the app generated feelings of being monitored, involved and cared for. Further it supported attentiveness to and reflection of own well- being but could also serve as a reminder of illness. Some patients described that vigor, comorbidity, and cognitive side effects from the treatment influenced the motivation for and ability to symptom report. The information pages with self care advice were useful and appreciated and gave an idea of what was to be expected during treatment. Patients requested added and more comprehensive information on psychological symptoms and dietary advice. Conclusions: The Interaktor app is a userfriendly and convenient alternative for patients contact and involvement with health care that aided symptom management, self-care and further enhanced patients participation in their care. Clinical trial identification: NCT02479607 and NCT02477137. Legal entity responsible for the study: Karolinska Institutet. Funding: Swedish Cancer Foundation, Swedish Research Council, Swedish Research Council for Health, Working Life and Welfare and Karolinska Institutet. Disclosure: All authors have declared no conflicts of interest.
Variables
Results (%)
Contents Navigation Graphic design Utility
81% 79% 83% 90%
*N ¼ 116 Oncology chemo patients level agreement 83% of patients consider this app useful for them and 86% believe it would help to improve CINV management. 94% of patients would recommend it to other patients.
Conclusions: The CINV app addresses main concerns for patients receiving chemotherapy such as the clinical situation and individual emetic risk of patient or complexity of the prescribed antiemetic regimen and impact of CINV in patients daily life. By soliciting feedback from oncology patients, we ensured that the app was acceptable and beneficial for them although some improvement points were suggested. Reporting of symptoms after CT enhances CINV management, self-care, and participation without being a burden to patients, indicating that app can be used in clinical practice by patients. Legal entity responsible for the study: Vifor Pharma Espa~ na SL. Funding: Vifor Pharma Espa~ na SL. Disclosure: P. Fernandez: Advisory / Consultancy, advisor activities: Vifor Pharma Espa~na. All other authors have declared no conflicts of interest.
CN3
Colorectal telephone assessment pathway (CTAP): A viable means of shortening time to a definitive diagnosis of colorectal cancer (CRC)
H. Watson GI Surgery / Colorectal, Guy’s and St. Thomas’ Hospital NHS Trust, London, UK CN2
Patient’s usability test results of a CINV diary application for smartphones 1
2
P. Fernandez , Y. Escobar Alvarez Lung Funtional Unit, Catalan Institute of Oncology, Hospital Duran i Reynals, non, Barcelona, Spain, 2Medical Oncology, Hospital General Universitario Gregorio Mara~ Madrid, Spain
1
Background: Chemotherapy-induced nausea and vomiting (CINV) continue to be a clinical problem, particularly in the delayed phase. CINV lack of control worsens the quality of life of patients and it is associated with complications increasing costs for healthcare services. CINV app is a free service addressed to patients treated with emetogenic chemotherapy (CT), empowering patients to report CINV impact in life and relevant information. This study aims to evaluate the usability and acceptability of a smartphone app to improve CINV management in patients receiving CT. Methods: We used 4-dimensions test (content, graphic design, navigation and clinical utility) to evaluate APP’s usability and acceptability. Clinical and technical researchers worked together to develop the app’s test. 44 oncology nurses of 33 representative Spanish hospitals were invited to participate (from 31st January to 5th April 2019) enrolling a total amount of 116 oncology patients for testing purposes. After using the app for a chemo cycle the patient was asked to fulfil an online usability test. Results: Described in the table.
Background: It is well documented that survival of CRC is dependent on early diagnosis. In England, the Department of Health’s cancer policy states that patients with symptoms of suspected cancer must be seen and assessed by the specialist team within 2 weeks of a referral by their General Practitioner (GP). The traditional 2 week wait (2ww) referral route involves these patients being seen in clinic within 2 weeks, where they are assessed and an investigation is booked, taking up to 4 weeks for first investigation and diagnosis. We have introduced a novel Straight to Test / CTAP for these patients, which rationalises the patient journey, ensuring that the patient has the right test first time, without delay. Methods: Our service is a Consultant Nurse led Straight to Test / CTAP. All 2ww patients referred by the GP with suspected CRC are assessed via the CTAP. Upon receipt of the electronic referral from their GP, a colorectal assessment is carried out via telephone within 48 hours of referral by the Consultant nurse or a member or her specialist nursing team. The patient is then triaged for the most appropriate investigation, according to a protocol, which is then booked within 2 weeks of the GPs referral. Results: The CTAP has been running now for 5 years with over 4000 patients being assessed via this route. In 2017 & 2018 the cancer yield from our service was 4% which matches that of traditional out-patient assessments routes. However we were able to reduce the patient pathway by 10 days by the introduction of the CTAP. 70% of patients had an endoscopy procedure as their first investigation and 28% had a radiological investigation (usually CT Colonography). 90% of patients had their diagnosis or given the all clear by day 14. Conclusions: This pathway has significantly shortened the patient’s pathway and time diagnosis for our patients, meaning that those patients with CRC are diagnosed by day 14. Patients with other pathologies are also diagnosed quicker and those patients with no serious pathology are reassured and discharged back to their GP We have managed to reduce waiting times from referral to diagnosis and to ensure all patients on the 2ww pathway have a more streamline patient focused experience, avoiding unnecessary hospital visits.
C European Society for Medical Oncology 2019. Published by Oxford University Press on behalf of the European Society for Medical Oncology. V
All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/30/Supplement_5/mdz272.001/5577883 by guest on 24 October 2019
M-T. Crafoord, M. Fjell, M.I. Nilsson, M.I. Nilsson, K. Sundberg, A. Langius-Eklo¨f Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
Table: CN2 Average of patients that agree for each dimension