As cancer science evolves, so too does cancer treatment. More and more patients are able to take oral chemotherapies that are as effective as intravenous chemotherapy without some of the more toxic side effects. Many patients also find these treatments preferable as they involve fewer doctors’ office visits, and give them more control over their treatment. But oral therapies present a unique set of challenges for cancer patients including symptom management and adherence to medication schedules outside the system of infusion centers and doctor offices that helped patients manage earlier therapies.
Joel Fishbein, a graduate student at University of Colorado Boulder, was part of a team at Massachusetts General Hospital (MGH) that created and then evaluated a smartphone app to encourage cancer patients to take their oral chemotherapy as prescribed. The evaluation of the mobile app is being presented at the American Society for Clinical Oncology (ASCO) Annual Meeting 2017.
From February 2015 through December 2016, 181 patients at MGH in Boston and two MGH community affiliates diagnosed with different kinds of cancer and prescribed oral chemotherapy were randomized into two groups: one group received the smartphone mobile app; the other received standard care.
“Many patients find it difficult to stay adherent to their oral chemotherapy regimens, especially when they’re experiencing symptoms and side effects,” says Fishbein, a graduate student in clinical psychology. “Our goal was to create an app that could help patients keep track of their oral chemotherapy prescription, symptoms, and side effects; help them find information about managing those symptoms and side effects; and keep their care team in the loop about how they’re doing.”
The mobile app includes a medication treatment plan with alerts, a symptom reporting module, education library, and cancer-specific resources. Adherence was measured by electronic pill cap (Medication Event Monitoring System; http://www.medamigo.com/) and self-report (Morisky Medication Adherence Scale; MMAS). To assess their symptoms, mood, and satisfaction with care, participants completed the MD Anderson Symptom Inventory, Hospital Anxiety & Depression Scale (HADS) and Functional Assessment of Chronic Illness Therapy-Treatment Satisfaction (FACIT-TS) at baseline and at 12 weeks.
“We learned that the app was particularly useful for people with anxiety, and those struggling with sticking to their medication schedule,” says Fishbein. “This is an important finding as we learn how we can make these kinds of treatments as effective as possible.”
Fishbein’s faculty advisor is Joanna Arch, PhD, a CU Cancer Center member and assistant professor in CU Boulder’s Department of Psychology and Neuroscience. The focus of her work involves understanding the anxiety and stress of coping with cancer and developing interventions.
“Apps are a promising way to support patients during their cancer treatment, especially when they’re taking their chemotherapy medications at home and seeing their oncologist less frequently,” Fishbein says. “With an app, patients can get quick access to information about their care, no matter where they are, and get in touch with their care teams when they need to. So I believe this approach could make cancer treatments easier and more effective for patients.”
CU Boulder is part of the University of Colorado Cancer Center consortium. CU Cancer Center is the only comprehensive cancer center as designated by the National Cancer Institute in the state of Colorado.
The app is not available publicly and there is no word when it might become available.