Genital Neoplasm, Female Clinical Trial
Official title:
Post-Op Gynecological Oncology Web-Based App Study
Purpose: The purpose of this study will be to test the use of a web-based mobile application
(app) initiated at the time of hospital discharge to engage and monitor patients in order to
efficiently deliver better outcomes. The mobile app will be used to remind patients of
discharge instructions, assess adherence treatment regimens, and evaluate symptoms.
Rationale: Approximately 60% of patients with ovarian cancer have advanced stage disease at
diagnosis, and thus aggressive surgical procedures are often medically necessary. Recent
evidence suggests that nearly one in five patients hospitalized for ovarian cancer surgery
will be readmitted within 30 days of discharge. Patients readmitted within 30 days have a 50%
increase in one-year mortality rates and significantly increased costs of care. In addition,
many of the conditions and complications that led to readmission could potentially have been
avoided with more intensive post-surgical follow-up care. Mobile health technologies can
effectively and efficiently connect patients with their healthcare team and have been shown
to improve treatment adherence and reduce avoidable ER visits and hospitalizations.
The investigators plan to enroll 15 subjects per study arm, for a total of 30 participants.
Potential subjects for recruitment will be identified from the electronic health records
system of the West Cancer Center. The West Cancer Center employs four physicians specializing
in gynecologic oncology who account for nearly 100% of open abdominal hysterectomies among
ovarian cancer patients in the region. All four physicians have expressed strong support of
the study and have agreed to actively participate by allowing screening of electronic health
record data to identify appropriate patients and referral of eligible patients to the Nurse
Coordinator for possible consent. The Nurse Coordinator will approach eligible patients
during their surgery planning visit or in the hospital prior to surgery to provide an
overview of the research study and seek informed consent.
Patients who provide informed consent will immediately be asked to complete a brief baseline
survey about their preferences for receiving prompts, either via email or via cell phone
using a text message. After survey administration, all patients will be registered in the
mobile health app, which will be used provide discharge care instructions and monitor their
progress upon discharge. Study participants will then be randomized into one of two arms: 1)
active prompts to use the study app or 2) use of study app, but no prompts. All participants
will be followed for a minimum of 30 days and will be asked to complete a follow-up survey
during a scheduled in-clinic appointment at the end of the study.
Baseline and follow-up questionnaires will collect data on quality of life (SF-12), physical
symptoms, activities of daily life, prescription narcotic use, health literacy, demographics
and use of health care services (e.g. ER visit, hospital admission, clinic appointment). The
web-based app will be used to remind patients of discharge instructions, ask questions
related to current prescription pain medication use, new symptoms, or changes in the severity
of symptoms.
Data from this study will be derived from the following sources: electronic health data to
capture treatment changes and disease severity; responses to baseline and follow-up
questionnaires to measure self-reported behaviors, including quality of life, use of
prescription pain medication and care utilization; and post-study semi-structured interviews
with physicians and patients to provide qualitative feedback.
;
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