Abstract P6-12-07: A prospective pilot study of holistic wellness assessment using an innovative mobile technology in advanced breast cancer patients attending a tertiary cancer institute in India
Authors: Gupta Puneet , Yadav Mansi , Mahatma Shilpa , Kumar Tarun , Alford Sharon Hensley 
Published: March 2020

Abstract
Background: It has been recognized that all dimensions of a patient’s health are important during diagnosis, treatment, and follow-up/survivorship. We tested the implementation of a holistic wellness assessment that captures physical, social, financial, mental, and spiritual dimensions during patient visits to a single oncology tertiary care institute in Delhi, India.
Method: Consecutive cancer patients (first and recurrent diagnosis) were evaluated for this prospective study 2018-2019. This analysis was limited to female breast cancer patients. All patients were assessed by a dedicated oncology psychologist who captured parameters with a brief holistic wellness assessment. The holistic wellness assessment measures captured included whether the patient was experiencing any physical discomfort, sleep disturbances, mood changes, signs of depression, and recorded spiritual beliefs, insurance status, and family/friend engagement. Assessments were initially performed on paper and then a mobile application was used to support the study.
Results: A total of 22 female breast cancer patients, between the ages 37 and 75 years (mean age 52), were surveyed. Of these patients, the cases were primarily late stage (III and IV) invasive ductal carcinoma. The most common physical symptoms reported were back pain (36%), headache (45%), chest tightness (41%), fever (41%), and loss of appetite (36%). Over 80% of women reported trouble with at least one sleep dimension (difficulty falling asleep, waking early, interrupted sleep, waking from pain). Many women reported disturbances in their mood. Nearly 50% reported having worrying thoughts and sadness while 60% reported weeping easily. Irritability (36%), provocability (41%), and anger (32%) were also reported. A majority (64%) reported believing in god. Nearly all women’s care (90%) was supported by government insurance coverage.
Conclusion: We demonstrate that evaluation of a patient’s holistic wellness is possible. Using digital technology that leverages a mobile application enables granular patient assessment. This type of assessment can feed into the overall treatment formulation to support a positive outcome. Important measures of wellness beyond treatment effects were captured and cases were then referred for additional support services as needed. The use of a mobile application to enable ease of data collection supports a possible bi-directional engagement between the patients and doctors with the intent to improve patient outcomes.
Citation Format: Puneet Gupta, Mansi Yadav, Shilpa Mahatma, Tarun Kumar, Sharon Hensley Alford. A prospective pilot study of holistic wellness assessment using an innovative mobile technology in advanced breast cancer patients attending a tertiary cancer institute in India [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-12-07.