A mobile health app for real-time symptom monitoring in patients with cancer during COVID-19: feasibility, acceptability, and utility

Patients undergoing cancer treatment often endure significant symptom burden, necessitating timely management to prevent severe complications. The COVID-19 pandemic highlighted the need for real-time remote symptom monitoring, particularly for cancer patients at heightened risk due to immunosuppression from cancer and chemotherapy. This 24-week, single-arm intervention study was conducted from July 2020 to May 2021 at the Stephenson Cancer Center Infusion Clinic in Oklahoma, USA. This study assessed the feasibility, acceptability, and utility of the Symptom Tracker smartphone app. The app prompted 128 patients receiving cytotoxic chemotherapy to report symptoms associated with cancer, cancer treatment, and COVID-19. Reports indicating elevated COVID-19 risk automatically triggered notifications to nursing staff for follow-up and testing. Primary outcomes included daily symptom reporting adherence and patient satisfaction. Participants (N = 128) had a mean age of 57.6 years (SD = 13.0), with 77.3% being female. Approximately 10,000 daily symptom reports were completed, representing 46% of all study days. The app facilitated 302 patient-initiated contacts with cancer treatment staff. During the study period, seven participants (5.5%) tested positive for COVID-19 and were successfully triaged. Weekly feedback revealed that 76.8%-89.1% of participants considered the frequency of assessments “about right.” The Symptom Tracker app demonstrated feasibility, acceptability, and utility, as evidenced by high symptom reporting adherence, user satisfaction, and effective remote symptom management across a diverse patient population in Oklahoma. Our approach shows promise for supporting oncology care, enhancing real-time monitoring of symptom variability, and ensuring rapid response to critical symptoms. ClinicalTrials.gov Identifier: NCT04397614, Registration date: May 22, 2020.