%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 7
%N 
%P e50550
%T Supportive Digital Health Service During Cancer Chemotherapy: Single-Arm Before-and-After Feasibility Study
%A Fridriksdottir,Nanna
%A Ingadottir,Brynja
%A Skuladottir,Kristin
%A Zoëga,Sigridur
%A Gunnarsdottir,Sigridur
%+ Landspitali- The National University Hospital of Iceland, Hringbraut, Reykjavik, 101, Iceland, 354 543 1000 ext 6065, nannafri@landspitali.is
%K web portal for patients with cancer
%K supportive digital health service
%K symptom monitoring
%K self-management support
%K feasibility
%K usability
%K acceptability
%K patient education
%K health engagement
%K patient-reported outcomes
%K digital health service
%K patient portal
%K electronic health records
%K mobile phone
%D 2023
%7 22.12.2023
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Digital supportive cancer care is recommended to improve patient outcomes. A portal was designed and embedded within the electronic medical record and public health portal of Iceland, consisting of symptom and needs monitoring, educational material, and messaging. Objective: This study aims to assess (1) portal feasibility (adoption, engagement, usability, and acceptability), (2) potential predictors of usability and acceptability, and (3) the potential impact of the portal on patient-reported outcomes. Methods: This was a single-arm, before-and-after feasibility study at a university hospital among patients with cancer who were undergoing chemotherapy. Participation included filling out the Edmonton Symptom Assessment System–Revised (ESASr) weekly and the Distress Thermometer and Problem List (DT&PL) 3 times; reading educational material and messaging; and completing study questionnaires. Clinical and portal engagement data were collected from medical records. Data from patients were collected electronically at baseline and 7 to 10 days after the third chemotherapy round. Usability was assessed using the System Usability Scale (score 0-100), and acceptability was assessed using a 35-item survey (score 1-5). Patient-reported outcome measures included ESASr and DT&PL; a single-item scale for quality of life, family support, and quality of care; and multi-item scales for health literacy (Brief Health Literacy Screener), health engagement (Patient Health Engagement Scale), self-care self-efficacy (Self-Care Self-Efficacy scale), symptom interference (MD Anderson Symptom Inventory), knowledge expectations (Hospital Patients’ Knowledge Expectations), and received knowledge (Hospital Patients’ Received Knowledge). Health care professionals were interviewed regarding portal feasibility. Results: The portal adoption rate was 72% (103/143), and the portal use rate was 76.7% (79/103) over a mean 8.6 (SD 2.7) weeks. The study completion rate was 67% (69/103). The combined completion rate of the ESASr and DT&PL was 78.4% (685/874). Patients received a mean 41 (SD 13) information leaflets; 33% (26/79) initiated messaging, 73% (58/79) received messages, and 85% (67/79) received follow-up phone calls. The mean System Usability Scale score was 72.3 (SD 14.7), indicating good usability. Usability was predicted by age (β=−.45), ESASr engagement (β=.5), symptom interference (β=.4), and received knowledge (β=.41). The mean acceptability score, 3.97 (SD 0.5), was above average and predicted by age (β=−.31), ESASr engagement (β=.37), symptom interference (β=.60), self-care self-efficacy (β=.37), and received knowledge (β=.41). ESASr scores improved for total symptom distress (P=.003; Cohen d=0.36), physical symptoms (P=.01; Cohen d=0.31), and emotional symptoms (P=.01; Cohen d=0.31). Daily symptom interference increased (P=.03; Cohen d=0.28), quality of life improved (P=.03; Cohen d=0.27) and health engagement (P=.006; Cohen d=0.35) improved, while knowledge expectations decreased (P≤.001; Cohen d=2.57). Health care professionals were positive toward the portal but called for clearer role delineation and follow-up. Conclusions: This study supports the feasibility of a support portal and the results indicate the possibility of improving patient outcomes, but further developments are warranted. 
%M 38015268
%R 10.2196/50550
%U https://formative.jmir.org/2023/1/e50550
%U https://doi.org/10.2196/50550
%U http://www.ncbi.nlm.nih.gov/pubmed/38015268