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技术应用:利用数字健康技术推动药物研发。

Technology Applications: Use of Digital Health Technology to Enable Drug Development.

作者信息

Liu Joyce F, Lee Jung-Min, Strock Ellie, Phillips Ruth, Mari Karine, Killiam Bill, Bonam Matthew, Milenkova Tsveta, Kohn Elise C, Ivy S Percy

机构信息

Joyce F. Liu, Dana Farber Cancer Institute, Boston; Ellie Strock, Ruth Phillips, and Karine Mari, Voluntis, Cambridge, MA; Jung-min Lee, Elise C. Kohn, and S. Percy Ivy, National Cancer Institute, Bethesda, MD; Bill Killiam, User-Centered Design, Ashburn, VA; and Matthew Bonam and Tsveta Milenkova, AstraZeneca, Cambridge, United Kingdom.

出版信息

JCO Clin Cancer Inform. 2018 Dec;2:1-12. doi: 10.1200/CCI.17.00153.

Abstract

PURPOSE

This pilot study developed and evaluated the feasibility, usability, and perceived satisfaction with an end-user mobile medical application and provider web portal. The two interfaces allowed for remote monitoring, provided daily guidance in the management of hypertension and diarrhea, and allowed for rapid management of adverse events during a clinical trial of olaparib and cediranib.

PATIENTS AND METHODS

eCO (eCediranib/Olaparib) was designed for patient self-reported, real-time management of hypertension and diarrhea using remote monitoring. eCO links to a Bluetooth-enabled blood pressure (BP) monitor and transmits data to a secure provider web portal. eCO use was assessed for suitability, usability, and satisfaction after 4 weeks using a 17-item questionnaire. Metrics regarding patient-reported BP and diarrhea events were analyzed.

RESULTS

Sixteen patients enrolled in the pilot. A total of 98.2% of expected BP values were reported: 94.2% via Bluetooth and 5.8% entered manually. Twelve patients experienced 21 BP events (systolic BP > 140 and/or diastolic BP > 90 mmHg on two consecutive readings); data from cycle 1 were comparable to the study database. Thirteen patients reported diarrhea (more than one stool per 24 hours over baseline) categorized as grade 1 or 2, which was comparable to the study database. Survey analysis showed that patients had statistically significant, positive responses to the use of the eCO application. Patients indicated eCO use made them feel more involved in their care and better connected to their health care team. The only aspect of the application that did not show a statistically significant positive response was the process of reporting diarrhea.

CONCLUSION

The eCO application was designed to assist in managing acute treatment-related events most often associated with treatment discontinuation, need for drug holidays, or dose interruption. Hypertension and diarrhea events reported via eCO allowed rapid provider response and a positive overall patient experience.

摘要

目的

本初步研究开发并评估了一款终端用户移动医疗应用程序和医疗服务提供者网络门户的可行性、可用性及感知满意度。这两个界面支持远程监测,为高血压和腹泻的管理提供每日指导,并在奥拉帕利和西地尼布的临床试验期间实现不良事件的快速管理。

患者与方法

eCO(西地尼布/奥拉帕利电子应用程序)旨在通过远程监测实现患者自我报告的高血压和腹泻实时管理。eCO连接到支持蓝牙的血压监测仪,并将数据传输到安全的医疗服务提供者网络门户。使用一份包含17个条目的问卷,在4周后评估eCO的适用性、可用性和满意度。分析了与患者报告的血压和腹泻事件相关的指标。

结果

16名患者参与了该初步研究。共报告了98.2%的预期血压值:94.2%通过蓝牙传输,5.8%手动输入。12名患者经历了21次血压事件(连续两次读数时收缩压>140和/或舒张压>90 mmHg);第1周期的数据与研究数据库相当。13名患者报告腹泻(超过基线每24小时排便一次以上),分类为1级或2级,与研究数据库相当。调查分析表明,患者对使用eCO应用程序有统计学上显著的积极反应。患者表示使用eCO让他们感觉更参与到自己的护理中,与医疗团队的联系也更好。该应用程序中唯一未显示出统计学上显著积极反应的方面是腹泻报告流程。

结论

eCO应用程序旨在协助管理最常与治疗中断、药物假期需求或剂量中断相关的急性治疗相关事件。通过eCO报告的高血压和腹泻事件使医疗服务提供者能够快速做出反应,并为患者带来积极的总体体验。

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