Hospital General Universitario Gregorio Marañon, Madrid, Spain.
Hospital Clinic Barcelona, Barcelona, Spain.
JMIR Mhealth Uhealth. 2020 Oct 16;8(10):e20480. doi: 10.2196/20480.
Oral antineoplastic agents (OAAs) have revolutionized cancer management. However, they have been reported with adverse side effects and drug-drug interactions. Moreover, patient adherence to OAA treatment is critical. Mobile apps can enable remote and real-time pharmacotherapeutic monitoring of patients, while also promoting patient autonomy in their health care.
The primary objective was to analyze the effect of using a mobile app for the follow-up of patients with oncohematological malignancies undergoing treatment with OAAs on their health outcomes. The secondary objectives were to analyze the role of the app in communication with health care professionals and patient satisfaction with the app.
We performed a comparative, quasi-experimental study based on a prepost intervention with 101 patients (control group, n=51, traditional pharmacotherapeutic follow-up vs intervention group, n=50, follow-up through e-OncoSalud, a custom-designed app that promotes follow-up at home and the safety of patients receiving OAAs). The effect of this app on drug safety, adherence to treatment, and quality of life was evaluated.
With regard to drug safety, 73% (37/51) of the patients in the control group and 70% (35/50) of the patients in the intervention group (P=.01) presented with drug-related problems. The probability of detecting an insufficiently treated health problem in the intervention group was significantly higher than that in the control group (P=.04). The proportion of patients who presented with side effects in the intervention group was significantly lower than that in the control group (P>.99). In the control group, 49% (25/51) of the patients consumed some health resources during the first 6 months of treatment compared with 36% (18/50) of the patients in the intervention group (P=.76). Adherence to treatment was 97.6% (SD 7.9) in the intervention group, which was significantly higher than that in the control group (92.9% [SD 10.0]; P=.02). The EuroQol-5D in the intervention group yielded a mean (SD) index of 0.875 (0.156), which was significantly higher than that in the control group (0.741 [0.177]; P<.001). Approximately 60% (29/50) of the patients used the messaging module to communicate with pharmacists. The most frequent types of messages were acknowledgments (77/283, 27.2%), doubts about contraindications and interactions with OAAs (70/283, 24.7%), and consultations for adverse reactions to treatment (39/283, 13.8%). The satisfaction with the app survey conducted in the intervention group yielded an overall mean (SD) score of 9.1 (0.4) out of 10.
Use of e-OncoSalud for the real-time follow-up of patients receiving OAAs facilitated the optimization of some health outcomes. The intervention group had significantly higher health-related quality of life and adherence to treatment than the control group. Further, the probability of the intervention group presenting with side effects was significantly lower than that of the control group.
口服抗肿瘤药物(OAAs)的出现彻底改变了癌症的治疗方式。然而,它们已被报道具有不良反应和药物相互作用。此外,患者对 OAA 治疗的依从性至关重要。移动应用程序可以实现对患者进行远程实时药物治疗监测,同时也能促进患者在医疗保健方面的自主权。
主要目的是分析使用移动应用程序对接受 OAAs 治疗的血液恶性肿瘤患者进行随访对其健康结果的影响。次要目的是分析应用程序在与医疗保健专业人员沟通方面的作用以及患者对应用程序的满意度。
我们进行了一项基于前后干预的比较性准实验研究,共纳入 101 例患者(对照组,n=51,传统药物治疗随访;干预组,n=50,通过 e-OncoSalud 进行随访,这是一款定制的应用程序,可促进患者在家中的随访和接受 OAAs 治疗的患者的安全性)。评估了该应用程序对药物安全性、治疗依从性和生活质量的影响。
在药物安全性方面,对照组 73%(37/51)的患者和干预组 70%(35/50)的患者(P=.01)出现了药物相关问题。干预组检测到治疗不足的健康问题的概率明显高于对照组(P=.04)。干预组出现副作用的患者比例明显低于对照组(P>.99)。在对照组中,与干预组相比,在治疗的前 6 个月内有 49%(25/51)的患者消耗了一些卫生资源(P=.76)。干预组的治疗依从率为 97.6%(SD 7.9),明显高于对照组的 92.9%(SD 10.0)(P=.02)。干预组的 EuroQol-5D 平均(SD)指数为 0.875(0.156),明显高于对照组的 0.741(0.177)(P<.001)。大约 60%(29/50)的患者使用消息传递模块与药剂师进行沟通。最常见的消息类型是确认(77/283,27.2%)、对 OAAs 的禁忌证和相互作用的疑问(70/283,24.7%)和治疗不良反应的咨询(39/283,13.8%)。干预组对应用程序满意度调查的总平均(SD)得分为 9.1(0.4)(满分 10 分)。
使用 e-OncoSalud 对接受 OAAs 治疗的患者进行实时随访有助于优化一些健康结果。干预组的健康相关生活质量和治疗依从性明显高于对照组。此外,干预组出现副作用的概率明显低于对照组。