G. Lee1, V. Kong2,3, C. Kapser4, S. Pathak4, J. Deleemans4, C. Robertson1, P. Wong5, J. M. Croke5, P. Chung3, and T. Rosewall6,7; 1Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, 2Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada, 3Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada, 4Zamplo Research, Calgary, AB, Canada, 5Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada, 6Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada, 7Department Radiation Oncology, University of Toronto, Toronto, ON, Canada
Purpose/Objective(s): To examine the feasibility of using a mobile phone app to remotely monitor patient-reported outcomes (PROs) during and immediately after radiation therapy (RT) for breast and prostate cancer. Materials/
Methods: English-speaking patients receiving RT for breast or prostate cancer were invited to participate in a single-center, longitudinal quality improvement project. Participants were asked to download a HIPAA/PHIPA compliant mobile phone app onto their personal device. Unsupervised participants used the app to report PRO-CTCAE at baseline, weekly during RT and up to 4 weeks after RT. Push notifications automatically delivered reminders to complete surveys. Participants were routinely seen by a radiation healthcare provider (HCP) once per week during RT. PROs were remotely monitored by Radiation Therapists during and after RT, with an intervention threshold of ‘moderate’ or greater symptom severity. The app also collected pre and post patient-centered communication data (PCC-Ca-6), and participant satisfaction. App use metrics were gathered from audit log timestamps (open and interacting). Results: From July 2023 to Feb 2024, 20 prostate and 20 breast cancer patients participated (31% of the eligible population). The mean completion rate for all PRO surveys across all time points was 75%. Mean age was 64 (SD 14; range 25-93) years, 50% were female, and 83% preferred to communicate in English. There were no statistically significant demographic differences between those who were: 1) enrolled and compliant (>70% survey completion); 2) enrolled but poorly compliant (<70% completion); and 3) approached but chose not to participate (p>0.7). During RT, PRO-CTCAE was reported 85 times (out of a possible 107), whereas HCPs documented 49 times using various quantitative scales (e.g. RTOG, ESAS). In the ‘post-RT’ period, PRO entries triggered early follow-up with 8 breast and 10 prostate patients. There were no significant differences between pre and post overall PCC-Ca-6 scores (mean: 110 vs. 108; p 0.35). On average, each patient logged into the app 16 times on 11 days. They spent an average of 7 minutes interacting with the app per session. At the end of the study, 65% of participants said they would recommend using the app to other RT patients. 7 participants voluntarily populated their personal app account with unsolicited details (e.g. other health conditions and symptoms). Conclusion: These preliminary results suggest that remote monitoring of PROs entered via a mobile app is feasible during and immediately after RT. It is minimally burdensome to patients across a broad range of demographics and has no impact on their perceptions of patient-centred communication. A randomized controlled trial will now evaluate the use of remote PRO monitoring to triage attendance at in-person Oncologist review visits to identify the efficacy of a PRO-based personalized approach to providing supportive care.
