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. 2019 Apr 1;5(1):e10187.
doi: 10.2196/10187.

Usability, Acceptability, and Usefulness of an mHealth App for Diagnosing and Monitoring Patients With Breakthrough Cancer Pain

Jaime Boceta #  1 , Daniel Samper #  2 , Alejandro de la Torre #  3 , Rainel Sánchez-de la Rosa #  4 , Gloria González #  5
Affiliations

Usability, Acceptability, and Usefulness of an mHealth App for Diagnosing and Monitoring Patients With Breakthrough Cancer Pain

Jaime Boceta et al. JMIR Cancer. .

Abstract

Background: Breakthrough pain is a major problem and a source of distress in patients with cancer. We hypothesized that health care professionals may benefit from a real-time mobile app to assist in the diagnosis and monitoring of breakthrough cancer pain (BTcP).

Objective: This study aimed to test the usability, acceptability, and usefulness in real-world practice of the mobile App INES·DIO developed for the management of patients with BTcP.

Methods: This study consisted of a survey of a multidisciplinary sample of 175 physicians who evaluated the mobile app after testing it with 4 patients with BTcP each (for a total of 700 patients). The digital profile of the physicians, use of the different resources contained in the app, usefulness of the resources, acceptability, usability, potential improvements, intention to use, and additional resources to add were recorded.

Results: Of the 175 physicians, 96% (168/175) were working in public hospitals. They had an average of 12 (SD 7) years of experience in BTcP and almost all (174/175, 99.43%) had an active digital profile. The Eastern Cooperative Oncology Group and Karnofsky performance scales, the Visual Analogue Scale, and the Davies algorithm to diagnose BTcP were the most frequently used tools with patients and were assessed as very useful by more than 80% (140/175) of physicians. The majority (157/175, 90%) answered that App INES·DIO was well designed and 94% (165/175) would probably or very probably recommend it to other colleagues. More than two-thirds indicated that the report provided by the app was worth being included in patients' clinical records. The most valued resource in the app was the recording of the number, duration, and intensity of pain flares each day and baseline pain control to enhance diagnosis of BTcP. Additional patient-oriented cancer pain educational content was suggested for inclusion in future versions of App INES·DIO.

Conclusions: Our study showed that App INES·DIO is easy to use and useful for physicians to help diagnose and monitor breakthrough pain in patients with cancer. Participants suggested the implementation of additional educational content about breakthrough pain. They agreed on the importance of adding new clinical guidelines/protocols for the management of BTcP, improving their communication skills with patients, and introducing an evidence-based video platform that gathers new educational material on BTcP.

Keywords: App INES·DIO; breakthrough cancer pain; mHealth; mobile app.

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Conflict of interest statement

Conflicts of Interest: JB has received personal fees from Grünenthal, Esteve, and Teva Pharmaceutical Industries, and nonfinancial support from Grünenthal. DS has received personal fees from Teva Pharmaceutical Industries, and RSR works in the medical department of Teva Pharmaceutical Industries.

Figures

Figure 1
Figure 1
Screenshots of App INES·DIO: a) starting workflow of the app, b) general information and toolbar for a new patient registry, c) definitions of breakthrough cancer pain (BTcP), d) diagnosis of BTcP.
Figure 2
Figure 2
Screenshots of App INES·DIO: e) other considerations for diagnosing breakthrough cancer pain (BTcP), f) evaluation of baseline pain, g) diagnosing neuropathic pain, and h) Edmonton’s Classification of cancer pain.
Figure 3
Figure 3
App INES·DIO workflow that guides a clinician to open a new patient registry.
Figure 4
Figure 4
App INES·DIO tools rated for clinical usefulness by professionals.
Figure 5
Figure 5
Content proposed by participants for a future version of app. BTcP: breakthrough cancer pain.
See this image and copyright information in PMC

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