Electronic patient reports outcomes and symptom monitoring for hematopoietic stem cell transplantation: A PILOT study.
Authors: Thiago William Carnier Jorge, Phillip Scheinberg, Melina Campagnaro, César Filho, Lorenzo Cartolano, Jean Singh, Luiz Felipe dos Prazeres, Camila Mota, Juliana Teodoro, Dimitra Delijaicov
Journal: Journal of Clinical Oncology (2021)

e13592 Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) present with various symptoms during hospitalization. The daily life routines of those undergoing HSCT change significantly before, during, and after the transplant. The utilization of technologies of digital support for oncological patients through mobile applications is a trend. WeCancer App is an electronic patient-reported outcome tool that provides on-demand multidisciplinary digital support by nurses, psychologists, and nutritionists. It also encompasses real-time remote patient monitoring, a notification center to the patient and medical staff, symptom monitoring, medication control, and a content hub with reliable medical information. Methods: This study examined whether electronic patient-reported outcomes [e-PROs]) in post-HSCT patients (6 patients included) up to 16 weeks after hospital discharge. The following were observed: number of symptoms reported, specific symptoms, toxicity after transplantation, application adherence, number of accesses, chat interactions, total hours of chat time. Patients could report common symptoms through a mobile application, for monitoring, symptom management, and follow-up with a specialized nurse, determining care based on digital support clinical protocols through online chat. The alerts made through the chat system guided the nursing team's clinical actions about online clinical management that can stratify the risk by crossing the intensity of symptoms by the ESAS scale (Manchester classification) and promoting preventive educational conduct of vigilance and risk mitigation. Results: Median follow-up for overall treatment was 16 weeks. The e-PRO completion rates were &gt; 90% at baseline and ≥ 80% at all on-treatment assessments and adherence. In-App adherence 329 reports were made 218 (66.26%) symptoms, 66 (20.06%) wellness, 30 (9.11%) gratitude and 15 (4.6%) exercise. Of the 64 chat interactions, there were 19.25 total hours and 18.05 average minutes per patient. The chat questions and interactions reported were: 48.2% symptoms, 27.7% treatment questions, 9.6% exams, 7.2% emotional aspect, 6% nutritional aspect and 1.3% medical devices. Some monitored patients (2) had guidance on outpatient graft versus host disease (GvHD) early in its onset with success avoiding a visit to the office or emergency room. Conclusions: We show the real-life benefits of incorporating ePRO into a post HSCT strategy adjunct to the treatment center. Symptoms that would only be brought to the physician in the next appointment were communicated in real-time to the transplant team, permitting early intervention and likely to reduce transplant-related deterioration and later interventions. The results suggest that further research should be done to prove the effectiveness of the App.