Abstract P1-11-19: E-DomSanté study on the improvement of care in oncology through digital technology
Authors: Quénel-Tueux N , Allam V , Desroches M , Duguey-Cachet O , Fillatreau C , Beaufrère P , Trézéguet V , Cassauba S , Portolan N , Caubet C , Rodrigues J , Saint-Upéry N , Gourgues A , Oukhemanou C , Savino F , Maurel M , Burbaud T , Jacques M , Lamurey D , Buyse P-E , Volpato-Coilier M , Michardière E , Hoppe S 
Published: May 2019

Abstract
Background: The effectiveness of remote follow-up of cancer patients through weekly medical questionnaires filled in on their smartphone has been reported in international studies. These studies demonstrated an improvement in quality of life (QoL) and survival of several months. The e-DomSanté study proposes the combined use of innovative technological tools for the improvement of patient care.
Patients and methods: This 2-year pilot study was carried out with patients followed-up for metastatic breast cancer who lived far from their treatment center. They were offered, in addition to their usual follow-up, weekly medical questionnaires (10 items) on an interactive tablet and a connected watch that registered their falls, bedtime and their general activity. All this data arrived on a secure portal. In the event of an alert, telemedicine was organized by remote consultation with exchange on a secure platform, in parallel, between the center's carers and the treating physician, nurse, pharmacist or the Territorial Support Unit. The evaluation criteria used included telemedicine and patients' QoL (FACT-B questionnaires) as well as their satisfaction with their care.
Results: The average age of the 15 patients included in the study was 65 years (range, 36-82 years) with one third of patients who had never used a computer or tablet. Those patients as well as elderly patients (≥ 75 years old) adapted very well to the technology simply with reinforced education and modification of the ergonomics of tablets and questionnaires. The requests for remote consultation were mainly due to 1) symptoms of deteriorating disease detected in advance, 2) toxicities relating to the treatment making it possible to adapt the therapy quickly, 3) the support oncological care (pain, depression or taken into terminal care at home) and 4) exhausted relatives. The QoL of all patients was stable or even improved despite progression of their metastatic disease in most cases. Practically all patients were satisfied (less fatigue due to less travel, high responsiveness of carers, security and confidence, less stress) with just a few criticisms (stress generated by the technology, no space for comments in the questionnaires and the restrictive nature of wearing the watch).
Conclusions: The e-DomSanté study confirms the contribution of digital technology in improving cancer care. This system avoids unnecessary consultations that are tiring for the patient and costly for society (transportation and hospitalization). It also avoids acute admissions through the emergency room. This method leads to an improvement in the QoL of patients and their satisfaction with their care. A second, much larger, multicenter randomized trial assessing patients' survival, QoL of patients and their relatives and medico-economic assessment will commence soon.
Citation Format: Quénel-Tueux N, Allam V, Desroches M, Duguey-Cachet O, Fillatreau C, Beaufrère P, Trézéguet V, Cassauba S, Portolan N, Caubet C, Rodrigues J, Saint-Upéry N, Gourgues A, Oukhemanou C, Savino F, Maurel M, Burbaud T, Jacques M, Lamurey D, Buyse P-E, Volpato-Coilier M, Michardière E, Hoppe S. E-DomSanté study on the improvement of care in oncology through digital technology [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-19.