Real-world implementation and user experience of tailored digital patient monitoring (DPM) modules for patients (pts) with locally advanced/metastatic (LA/M) cancer: Early readout analysis from a feasibility study.
Authors: Jaal Jana , Arriola Edurne , Rodriguez-Mues Mari Carmen , Edvardsen Anne , Silvoniemi Maria , Vettus Elen , Zairi Eleni , Roccato Marco , Schneider Sophie , Ammann Johannes 
Published: June 2022

e13608

Background: Poor control of disease- and treatment-related symptoms can impact negatively on quality of life and clinical outcomes in pts with cancer. DPM can improve cancer care by facilitating earlier symptom management, and reducing symptom burden and the need for emergency visits/consultations. However, adherence is a challenge for digital health solutions. We assessed adoption/adherence, duration of use, user experience, and perceived clinical impact of treatment-/disease-specific DPM modules in pts with LA/M non-small/small cell lung or HER2-positive breast cancer. Methods: Eligible pts were treated with locally approved and reimbursed drugs alongside use of the DPM modules. Pts could use Roche (drug-/drug class-specific) or Kaiku (drug class-specific only) DPM modules, all hosted on the Kaiku Health DPM platform. Respective thresholds for positive adoption and week 1–6 adherence (primary objectives) were 60% and 70%. Secondary objectives were user experience and clinical impact. Data were collected via questionnaires or extracted directly from the DPM platform. Results: At data cutoff (December 1, 2021), 93 pts were enrolled in eight clinics in Estonia, Finland, Greece, Norway, and Spain. The majority of pts had lung cancer, 52/79 (65.8%) had stage IV cancer, 72/79 (91.1%) had an Eastern Cooperative Oncology Group performance status of 0/1, and 30/52 (57.7%) were aged ≥60. Of the 52 pts and 20 healthcare professionals (HCPs) who completed a user experience questionnaire at Week 6, 37% and 30%, respectively, had previous experience with DPM. Pt adoption was 83.8% and adherence in weeks 1–6 was 73.4%. Average weekly time on the platform was ≤18 minutes for pts (median: 1–5 minutes per symptom questionnaire). HCPs spent a weekly average of 1–6 minutes per pt reviewing symptom reports on the platform. Most pts (87%) and HCPs (82%) were satisfied/very satisfied with the service and found it easy/very easy to use. Symptoms were described as fully/mostly covered by the tailored symptom questionnaire by 81% of pts and 71% of HCPs. Upon completion of a symptom questionnaire, pts received tailored feedback, on which half took action, most often with self-management instructions for mild/moderate symptoms. After 6 weeks of use, most pts and HCPs agreed that the Roche and Kaiku Health DPM service helps pts to be better informed about their disease/care (71% and 95%, respectively), facilitates better pt–care team discussions (79% and 81%), and improves cancer care (60% and 71%). Conclusions: The tailored DPM modules had high pt adoption/adherence in the first 6 weeks of use. Most pts and HCPs had positive user experiences with the DPM platform. Care impact experience was positive for both pts and HCPs in terms of improved pt education, pt–HCP communication, and overall cancer care.