Mobile health tool helps patients manage symptoms after cystectomy

An intervention using an electronic mobile health (mHealth) tool is not only feasible and acceptable but also delivers useful educational content and symptom management to patients undergoing radical cystectomy, according to a study.

“Postoperative education and symptom tracking are essential following cystectomy to reduce readmission rates and information overload,” the researchers said. “To address these issues, an internet-based tool was developed to provide education, alerts, and symptom tracking.”

This study examined the feasibility, acceptability, and impact of the mHealth tool on complication and readmission rates in 33 patients (aged >18 years) scheduled for cystectomy. Participants were asked to use the mHealth tool daily for the first 2 weeks, then less frequently up to 90 days following discharge.

The investigators summarized study variables using descriptive statistics. They defined feasibility as at least 50 percent of patients using the tool once a week and acceptability as patient satisfaction of >75 percent. [J Urol 2024;211:266-275]

The mHealth tool achieved feasibility, with most patients (90 percent) using it 1 week after discharge. However, engagement with the tool decreased to 50 percent over time. The main reason cited for nonengagement was technological difficulties. Acceptability by patients and providers was also high, with a satisfaction rating of >90 percent.

Of the patients, 36 percent had complications following discharge and 30 percent were readmitted within 90 days. Notably, engagement with the mHealth application varied but showed no statistically significant association with readmission (p=0.21).

“Future larger studies are needed to determine the tool's effectiveness in improving patient outcomes and its potential implementation into routine clinical care,” the investigators said.

Patient education

The findings of this study supported those of a previous one, in which the use of a healthcare application was found to be similarly feasible in providing more education to and perioperatively monitoring patients undergoing radical cystectomy for bladder cancer. [J Urol 2019;201:902-908]

“Testing is warranted to determine the extent to which implementation will improve patient triaging and reduce readmissions,” the authors of the above study said.

Another study also reported the feasibility of using smartphones and wearable technology to capture patient-reported symptoms and biometric data after cystectomy. This intervention also achieved a ‘highly usable’ rating by bladder cancer patients. [J Urol 2023;209:410-421]

The average time to complete this postoperative symptom intervention tool was 152 seconds or 2 1/2 minutes. Participants said that the daily survey was easy to use and would be a better way to communicate with the care team regarding symptoms than calling the clinic. [J Urol 2023;209:410-421]

“Frequency and severity of patient-reported symptoms appeared to cluster prior to or at the time of complication or unplanned healthcare encounters on visual-analogue mapping,” the authors said.

“Symptom scores may signal developing complications and help clinicians identify postsurgical patients who may benefit from intervention,” they noted. [J Urol 2023;209:410-421]