Mobile app captures symptoms, biometrics of bladder cancer patients after cystectomy

Patients with bladder cancer who underwent radical cystectomy may benefit from the use of smartphones and wearable technology to monitor their symptoms as well as biometric data, according to a recent study.

“Mobile health technology and integration of patient-reported outcome measures into clinical interventions have the potential to transform patient care,” the researchers said.

“Though patient-reported outcome measure management has been shown to improve outcomes in ambulatory care settings, few studies have examined remote patient-reported outcome measure assessment after major cancer surgery,” they added.

To address this knowledge gap, a feasibility and usability study with multiple phases was designed and performed. The researchers developed a mobile app-based postoperative symptom intervention tool, which was assessed by a focus group of bladder cancer patients and caregivers.

The team then prospectively enrolled patients prior to cystectomy. Participants completed the daily mobile postoperative symptom intervention tool and wore biometric monitoring devices for 30 days following discharge.

Assessments were done on the following outcomes: retention, usability, and postoperative symptom intervention tool completion. Finally, the researchers performed an exploratory analysis of daily symptoms and patient-generated health information to examine the association of signals with postsurgical complications and hospital readmission.

Over the 30-day recovery period, 15 patients (median age 72 years) successfully completed 78 percent of daily surveys. The average time to completion of the postoperative symptom intervention tool was about two and half minutes or 152 seconds. [J Urol 2023;209:410-421]

None of the patients found the daily survey difficult to use, and most of them stated that it would be a better method for communicating their symptoms with the care team instead of calling the clinic. Notably, it was discovered that the frequency and severity of patient-reported symptoms tended to cluster before or during complication or unplanned healthcare encounters on visual-analogue mapping.

“Using smartphone and wearable technology to capture patient-reported symptoms and biometric data is feasible and rated as highly usable by bladder cancer patients after cystectomy,” the researchers said. “Symptom scores may signal developing complications and help clinicians identify postsurgical patients who may benefit from intervention.”

An earlier trial reported the feasibility of using a healthcare application in providing more education to and perioperative monitoring of patients who underwent radical cystectomy of bladder cancer. [J Urol 2019;201:902-908]

In this study, patients who underwent radical cystectomy and had access to Wi-Fi at home were each provided a tablet preloaded with the m.Care healthcare application, an accelerometer, and vital sign equipment. They were then asked to watch educational videos, use the accelerometer, and monitor their own vital signs.

All participants used the accelerometer, of whom 60 percent regularly synced the data. Their average step count preoperatively was 5,679, indicating a sedentary population. This decreased to 1,351 during the inpatient stay and trended toward baseline level (3,156 steps) after the procedure. Vital signs were recorded on 85 percent of assigned days and had 33 triggers for intervention. [J Urol 2019;201:902-908]