Exploring Long-Term Determinants and Attitudes Toward Smartphone-Based Commercial Health Care Applications Among Patients With Cancer.

Abstract

Our study explores how attitudes of patients with cancer toward smartphone-based commercial health care apps affect their use and identifies the influencing factors. Of the 960 patients with cancer who participated in a randomized controlled trial for a smartphone-based commercial health care app, only 264 participants, who completed a survey on app usage experiences conducted between May and August 2022, were included in this study. Participants were categorized into three groups: Positive Persistence (PP), Negative Nonpersistence (NN), and Neutral (NE) on the basis of their attitude and willingness to use smartphone-based commercial health care apps. The Health-Related Quality of Life (QOL) Instrument (8 Items), European QOL (5 Dimensions; 5 Levels), The Human Interaction and Motivation questionnaire, and open-ended questionnaires were used to examine factors potentially influencing extended utilization of digital interventions. Despite demographic similarities among the three groups, only the PP and NE groups showed similar app usage compared with the NN group. The combined group (positive persistence and neutral) exhibited significant improvement in depression (<i>P</i> = .02), anxiety (<i>P</i> = .03), and visual analog scale scores (<i>P</i> = .02) compared with the NN group. In addition, patient interaction (<i>P</i> < .01) and the presence of a chatbot/information feature on the app (<i>P</i> < .01) demonstrated a significant difference across the three groups, with the most favorable response observed among the PP group. Patients were primarily motivated to use the app owing to its health management functions, while the personal challenges they encountered during app usage acted as deterrents. These findings suggest that maintaining a non-negative attitude toward smartphone-based commercial health care apps could lead to an improvement in psychological distress. In addition, the social aspect of apps could contribute to extending patient's utilization of digital interventions.