Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Front Public Health. 2022 Nov 4;10:978783. doi: 10.3389/fpubh.2022.978783. eCollection 2022.
This study aims to analyze the impact of the eOncosalud app on the management and follow-up of adverse effects (AE) in patients receiving oral antineoplastic agents.
We performed an observational, prospective study of cancer outpatients treated with oral antineoplastic agents (OAA), monitored by the eOncosalud app between August 2017 and October 2021. Safety variables were collected from eOncosalud: the number of AE; severity of the AE according to CTCAE, version 4.03; timelapse from app installation to first recorded AE; automatic recommendations issued; and the patient's acceptance of the recommendations made. To assess the impact of the recommendations generated by the algorithm, we calculated the positive predictive value (PPV) as the number of recommendations accepted out of the total number of recommendations generated. Safety-related patient messages were also analyzed (AE, drug-drug interactions, drug administration).
The app was downloaded and used by 186 patients (58.0% women), with a mean age of 59.0 years. A total of 1,368 AE were recorded, the most frequent being fatigue (19.37%), diarrhea (18.20%), and skin changes (9.21%). Regarding the recommendations issued by the app algorithm, 102 patients received 344 information brochures, 39 patients received 51 recommendations for supportive care to control AE, 60 patients received 240 recommendations to visit their primary care doctor, 14 patients received 16 recommendations to contact their specialist pharmacist or oncologist-hematologist, and 34 patients received 73 recommendations to go to the emergency room. The suggestion to go to the emergency room and contact the specialist pharmacist or oncologist-hematologist had a PPV of 0.51 and 0.35, respectively. Half of the patients (50.4%) used the messaging module. A total of 1,668 messages were sent. Of these, 47.8% were related to treatment safety: AE, 22.7%; drug-drug interactions, 20.6%; drug administration, 3.6%; and missing a dose, 1.0%.
The eOncosalud app enables close, real-time monitoring of patients treated with OAA. The automatic recommendations through the app's algorithm have optimized available healthcare resources. The app facilitated early detection of AE, thus enabling patients themselves to improve the safety of their treatment.
本研究旨在分析 eOncosalud 应用程序对接受口服抗肿瘤药物治疗的患者不良事件（AE）管理和随访的影响。
我们对 2017 年 8 月至 2021 年 10 月期间通过 eOncosalud 监测的接受口服抗肿瘤药物（OAA）治疗的癌症门诊患者进行了一项观察性、前瞻性研究。从 eOncosalud 收集安全性变量：AE 的数量；根据 CTCAE，版本 4.03 评估的 AE 严重程度；从应用程序安装到首次记录 AE 的时间间隔；发布的自动建议；以及患者对所提出建议的接受程度。为了评估算法生成的建议的影响，我们计算了阳性预测值（PPV），即接受的建议数量与生成的建议总数之比。还分析了与安全性相关的患者信息（AE、药物相互作用、药物给药）。
该应用程序被 186 名患者（58.0%为女性）下载并使用，平均年龄为 59.0 岁。共记录了 1368 例 AE，最常见的是疲劳（19.37%）、腹泻（18.20%）和皮肤改变（9.21%）。关于应用程序算法发布的建议，102 名患者收到了 344 份信息手册，39 名患者收到了 51 份控制 AE 的支持性护理建议，60 名患者收到了 240 份去看初级保健医生的建议，14 名患者收到了 16 份联系他们的专科药剂师或肿瘤学家-血液学家的建议，34 名患者收到了 73 份去急诊室的建议。去急诊室和联系专科药剂师或肿瘤学家-血液学家的建议的阳性预测值分别为 0.51 和 0.35。一半的患者（50.4%）使用了消息传递模块。共发送了 1668 条消息。其中，47.8%与治疗安全性有关：AE，22.7%；药物相互作用，20.6%；药物给药，3.6%；漏服一剂，1.0%。
eOncosalud 应用程序能够对接受 OAA 治疗的患者进行密切、实时的监测。通过应用程序的算法自动提出建议，优化了现有的医疗资源。该应用程序有助于早期发现 AE，从而使患者能够提高治疗安全性。
