Mobile health divide between clinicians and patients in cancer care: results from a cross-sectional international survey
JMIR 7(9):e13584 (link to the article)
technologies are increasingly being used to manage chronic diseases,
including cancer, with the promise of improving the efficiency and
effectiveness of care. Among the myriad of mobile technologies in health
care, we have seen an explosion of mobile apps. The rapid increase in
digital health apps is not paralleled by a similar trend in usage
statistics by clinicians and patients. Little is known about how much
and in what ways mobile health (mHealth) apps are used by clinicians and
patients for cancer care, what variables affect their use of mHealth,
and what patients’ and clinicians’ expectations of mHealth apps are.
study aimed to describe the patient and clinician population that uses
mHealth in cancer care and to provide recommendations to app developers
and regulators to generally increase the use and efficacy of mHealth
a cross-sectional Web-based survey, we explored the current utilization
rates of mHealth in cancer care and factors that explain the
differences in utilization by patients and clinicians across the United
States and 5 different countries in Europe. In addition, we conducted an
international workshop with more than 100 stakeholders and a roundtable
with key representatives of international organizations of clinicians
and patients to solicit feedback on the survey results and develop
insights into mHealth app development practices.
total of 1033 patients and 1116 clinicians participated in the survey.
The proportion of cancer patients using mHealth (294/1033, 28.46%) was
far lower than that of clinicians (859/1116, 76.97%). Accounting for age
and salary level, the marginal probabilities of use at means are still
significantly different between the 2 groups and were 69.8% for
clinicians and 38.7% for patients using the propensity score–based
regression adjustment with weighting technique. Moreover, our analysis
identified a gap between basic and advanced users, with a prevalent use
for activities related to the automation of processes and the
interaction with other individuals and a limited adoption for
side-effect management and compliance monitoring in both groups.
Conclusions: mHealth apps can provide access to clinical and economic data that are low cost, easy to access, and personalized. The benefits can go as far as increasing patients’ chances of overall survival. However, despite its potential, evidence on the actual use of mobile technologies in cancer care is not promising. If the promise of mHealth is to be fulfilled, clinician and patient usage rates will need to converge. Ideally, cancer apps should be designed in ways that strengthen the patient-physician relationship, ease physicians’ workload, be tested for validity and effectiveness, and fit the criteria for reimbursement.