Author/Editor		Grašič-Kuhar, Cvetka; Gortnar Cepeda, Tjaša; Kovač, Timotej; Kukar, Matjaž; Ružić Gorenjec, Nina
Title		The effect of mobile application for symptom management on quality of life during systemic treatment in early breast cancer
Type		članek
Publication year		2020
ISSN		2291-5222
Language		eng
Abstract		Background: Providing cancer patients undergoing systemic therapy with useful information about symptom management is essential to prevent deterioration of quality of life (QoL). Objective: In our study we tested the impact of a mobile phone application for symptoms management on the QoL and use of health resources. Methods: We conducted a prospective cohort study evaluating QoL in early breast cancer patients receiving systemic therapy in an outpatient setting at the Institute of Oncology Ljubljana, Slovenia. The intervention group (n=46) was provided with a mobile application for Android smartphones and received the usual care, while the control group (n=45) received the usual care only. The mobile application supported daily tracking of 50 symptoms and grading their severity (mild, moderate or severe) along with in-depth descriptions and recommendations for patients depending on symptom grade. Patient-related outcomes in both groups were assessed through the European Organisation for Research and Treatment of Cancer (EORTC) C-30 and BR-23 questionnaires, as well as Health Resource Usage Questionnaire at baseline, after the first week, after the first cycle and at the end of treatment. The primary goal was to assess the difference between groups in the global QoL and the summary score of the EORTC C-30 questionnaire after the first week, after the first cycle and at the end of treatment. Other scales were compared only exploratory. The secondary outcome was the use of health resources. Results: The mean difference between the groups in the global QoL after the first week was 10.1 (95% confidence interval (CI) [1.8, 18.5], P=.02) when adjusted for value at baseline and type of surgery. The difference in summary score between the intervention and the control group was statistically significant after the first week (higher for the intervention group; adjusted mean 8.9, 95% CI [3.1, 14.7], P=.003) and at the end of treatment (adjusted mean 10.6, 95% CI [3.9, 17.3], P=.002). The difference in use of health resources (visits to the doctor and hospitalizations) between the groups was not statistically significant (in the first week: P=.12; in the first cycle: P=.13). In the exploratory analysis, the application contributed to clinically important improvements in social, physical, role and cognitive functioning, while diminishing pain, appetite loss and systemic therapy side effects. Conclusions: The use of the mobile application enabled patients undergoing systemic therapy to cope better with symptoms as indicated by a better global QoL and summary score after the first week and by a better summary score at the end of treatment in comparison to the control group, but we have not found a statistically significant impact on the use of health resources.
Keywords		zgodnji rak dojk mobilna aplikacija spletne zdravstvene skupnosti mobilna aplikacija early breast cancer mobile application symptom management