Abstract Topic: 35. Quality of life and palliative care
Background: Patients with Multiple Myeloma receives costly medication - in this case the medication Bortezomib - which is normally prepared specifically for the individual patient, before the patients meet in the outpatient clinic. To avoid having to discard expensive medicine, it is important that it is only prepared for patients physically fit for receiving the treatment. Nurses at the outpatient clinic therefor contacts the patient per telephone prior to treatment to clarify if the patient are physically ready for treatment which is very time consuming and burdensome. Maybe this call could be replaced by a Mhealth app where the patients report their physically symptoms prior to treatment in order to increase the flexibility for patients with MM and to ease the increasing pressure on an already strained healthcare system.
Aims: Develop a questionnaire and test the usability of a Mhealth app to evaluate if patients are ready for treatment.
Methods: We conducted a clinical, prospective, parallel mixed-method study with a quantitative core and a qualitative supplementary component.
Quantitative data were obtained partly from Patient Reported Outcome (PRO) data and partly from registrations from the nurses at the outpatient clinic. PRO data were collected using a secure platform app. A purposeful questionnaire was developed for the app. This contained questions on common side effects to Bortezomib; neuropathy, fever, diarrhea, and constipation. If patients reported any side effects incompatible with their coming treatment, a nurse contacted them to clarify the degree of the side effects prior to a final decision on whether or not to schedule the treatment. Patients who reported no side effects were scheduled for treatment the next day. When patients left the study, they received a questionnaire about their experience of self-reporting side effects. Nurses at the outpatient clinic registered their time consummation on the Mhealth solution before and under the study. Quantitative data were obtained from individual, semi-structured interviews with patients and a focus group interview with healthcare professionals.
Results: 33 patients were included in the study. They had a median age of 64.3 years (Table 1). Sixteen patients were ≥ 65 years, three patients were ≥ 75 years, and one patient was even as old as 82 years. 319 questionnaires were completed. Of these 258 (80.56%) reported no side effects that were incompatible with treatment, and of these, 253 treatments were administered. In three cases, nurses and physicians became aware of the patients not being suitable for treatment before ordering. Thus, only two treatments were discarded during the entire study. In 61 cases, side effects that did not appear to be compatible with treatment were registered. The accuracy of evaluating the patients’ suitability for treatment using PRO data collected in “My Hospital” was 87 % (84 % sensitivity, 71 % specificity, 98 % PPV, and 20 % NPV).
Pro-data showed that the patients (n=29) were generally very satisfied and found the Mhealth easy to use. Four main themes emerged from the analysis: “Rather an app than a phone call”, “Technical trouble” , “Always help to be had”, and “True colors”.
Summary/Conclusion: The use of a Mhealth app instead of a telephonecall prior to treatment with Bortezomib is safe and preferable for both patients and healthcare staff. It is not less time-consuming for the nurses, but makes their work easier.
Keywords: Multiple myeloma, Bortezomib