Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives
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REVIEW ARTICLE
Digital health for optimal supportive care in oncology: benefits, limits, and future perspectives M. Aapro 1,2 & P. Bossi 3 & A. Dasari 4 & L. Fallowfield 5 & P. Gascón 6 & M. Geller 7 & K. Jordan 8 & J. Kim 9 & K. Martin 10 & S. Porzig 11 Received: 2 December 2019 / Accepted: 18 May 2020 # The Author(s) 2020
Abstract Background Digital health provides solutions that capture patient-reported outcomes (PROs) and allows symptom monitoring and patient management. Digital therapeutics is the provision to patients of evidence-based therapeutic interventions through software applications aimed at prevention, monitoring, management, and treatment of symptoms and diseases or for treatment optimization. The digital health solutions collecting PROs address many unmet needs, including access to care and reassurance, increase in adherence and treatment efficacy, and decrease in hospitalizations. With current developments in oncology including increased availability of oral drugs and reduced availability of healthcare professionals, these solutions offer an innovative approach to optimize healthcare resource utilization. Design This scoping review clarifies the role and impact of the digital health solutions in oncology supportive care, with a view of the current segmentation according to their technical features (connection to sensors, PRO collection, remote monitoring, selfmanagement in real time…), and identifies evidence from clinical studies published about their benefits and limitations and drivers and barriers to adoption. A qualitative summary is presented. Results Sixty-six studies were identified and included in the qualitative synthesis. Studies supported the use of 38 digital health solutions collecting ePROs and allowing remote monitoring, with benefits to patients regarding symptom reporting and management, reduction in symptom distress, decrease in unplanned hospitalizations and related costs and improved quality of life and survival. Among those 38 solutions 21 provided patient self-management with impactful symptom support, improvement of
Key message Digital solutions with ePROs and self-management can be incorporated in supportive care in oncology practice and provide benefits to: patients, e.g., reduced symptom burden and distress, increased symptom reporting, improved overall survival; healthcare professionals, with targeted patient management; payors, potentially with reduced supportive care-related costs and hospitalizations. * M. Aapro [email protected] 1
Medical Oncology, Genolier Cancer Center, Clinique de Genolier, Genolier, Switzerland
2
Institut Multidisciplinaire d’Oncologie (IMO), Clinique de Genolier, Case Postale (PO Box) 100, 1 Route de Muids, CH-1272 Genolier, Switzerland
3
Department of Medical Oncology, University of Brescia, Brescia, Italy
4
Department of Gastrointestinal Medical Oncology, Division of Cancer Medicine, MD Anderson Cancer Center, Houston, TX, USA
5
Sussex Health Outcomes Research & Education in Cancer (SHORE-C), Brighton & Sussex Medical School, Un
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