Purpose: Cancer patients on often experience side effects that, when undetected and uncontrolled, can lead to adverse events (AEs), resulting in diminished quality of life (QOL) and dose reduction or trial discontinuation. MyPatientPal, a smartphone app, was designed to capture daily patient-reported outcomes (PROs) of side effects to support earlier detection of AEs and improve patient QOL. This study investigated whether MyPatientPal captured greater variability in symptoms relative to weekly PROs and influenced QOL among patients on oral chemotherapy.
Sample and setting: The study was a multi-site trial across 6 cancer care sites (Michigan, US). Adult patients, age 18+, were recruited prior to starting oral chemotherapy. They had personal access to a smartphone or were provided with access during the study.
Methods/Procedures: Using a time-series interrupted design, participants completed weekly PROs of side effects for 4 weeks. Starting in week 5, they used MyPatientPal to complete daily PROs of side effects for 4 weeks. The primary outcome was patient QOL. Linear mixed models were examine the effect of symptom severity on patient QOL.
Results: The average participant (N=23) was 56.5 years, female (83%), married (74%), and white (74%). Over 50% had multi-modal treatment (surgery, chemotherapy, and radiation) and 50% had early/locally advanced versus regional/metastatic cancer. Results showed after controlling for demographics, clinical characteristics, and total number of symptoms, symptom severity significantly predicted QOL (β=-0.426, p<.001). Further, although there was no mean difference in weekly symptom severity before and after the introduction of MyPatientPal, daily symptom severity demonstrated significant inter- and intra-individual variability (p<.05).
Conclusion and clinical implications: Assessing daily variation in symptom severity may support earlier identification of problematic side effects better than less frequent assessments (e.g., weekly or monthly), enabling more timely interventions to prevent the occurrence of AEs and negative impact of side effects on patient QOL.