Feasibility and Implementation of a Digital Health Intervention Electronic Patient-Reported Outcomes-Based Platform for Telemonitoring Patients With Breast Cancer Undergoing Chemotherapy.

Abstract

Breast cancer (BC) is a leading cause of morbidity and mortality among women. Symptoms and treatment-related side effects often go undetected during routine follow-ups. Digital health interventions offer promising tools for real-time monitoring and personalized care. We aimed to implement and evaluate the feasibility of a mobile health electronic Patient-Reported Outcomes (ePRO)-based platform for telemonitoring patients with BC undergoing (neo)adjuvant chemotherapy. This prospective observational study enrolled patients with BC (TNM stages I to III) initiating chemotherapy at Barretos Cancer Hospital in Brazil. Participants were telemonitored using the <i>ThummiOnco</i> platform for 4-6 months, following a standardized protocol. Feasibility was assessed through platform usage, resolution of patient-reported symptoms (according to Common Terminology Criteria for Adverse Events) within 48-72 hours, and health care outcomes, including additional consultations, dose reductions, treatment interruptions/discontinuations, hospitalizations, and mortality. Statistical analysis was performed using descriptive statistics. Between October 2022 and June 2023, 67 eligible patients (median age 51 years) were included, with 62% receiving neoadjuvant chemotherapy. The median number of app accesses per patient was 38, with 6.65 daily symptom reports and 94% adherence. At 48 hours, 67% of patient-reported symptoms were fully resolved, whereas at 72 hours the resolution rate was 75.4%. Regarding resolution by grade, 83% of grade 1, 69.5% of grade 2, and 54.8% of grade 3 symptoms were fully resolved. Complementary consultations were needed for 34 patients. Dose reductions occurred in 10 (14.9%), treatment interruptions/discontinuations in 35 (52.2%), and hospitalizations in seven (10.4%). One patient died from progressive disease. Telemonitoring facilitated early symptom identification and management. Most reports were resolved through the platform, with minimal additional demands on the health care team. Future studies should assess cost-effectiveness and scalability across diverse populations.