TY - JOUR AU - Biran, Noa AU - Anthony Kouyaté， Robin AU - Yucel, Emre AU - McGovern, Gillian E AU - Schoenthaler, Antoinette M AU - Durling, Olivia G AU - Unawane, Rashmi AU - Schutt, Andrew AU - Panjabi, Sumeet PY - 2020 DA - 20/11/17 TI -复发和难治性多发性骨髓瘤患者的症状监测数字健康干预适应和评估:飞行员混合方法实现研究乔- Res JMIR形式SP - e18982六世- 4 - 11 KW - mHealth KW -数字医疗KW -电子patient-reported结果KW - ePRO千瓦patient-reported结果KW - PRO KW -移动KW - app KW -实现科学KW -多发性骨髓瘤KW -复发难治性多发性骨髓瘤AB -背景:复发、难治性多发性骨髓瘤(RRMM)是一种骨髓癌,需要全身治疗,往往导致严重症状负担。最近的研究发现，在临床环境中实施的电子患者报告结果(ePRO)干预措施对其他肿瘤人群有积极的结果。对于RRMM患者，缺乏类似方法的有效性证据。目标:最近关于数字卫生干预措施的建议要求公布迭代开发过程的描述，以提高可重复性和可比性。本研究是一项实施试点，旨在评估ePRO干预对RRMM患者的可接受性和适当性，并探讨其对临床工作流程的影响。方法:从新泽西州哈肯萨克的John Theurer癌症中心共招募了11名RRMM患者。患者使用一款移动应用程序在4次治疗中报告17种症状，每次治疗间隔一周。患者还可以特别报告症状。当报告达到预定义的阈值时，诊所会收到警报，患者会得到自动指导。 Study end points were assessed using qualitative and quantitative methods. Results: A total of 9 patients (mean age 69.7 years) completed the study. Overall, 83% (30/36) of weekly sessions were completed. Patients found the frequency and time required to complete reporting acceptable. All patients agreed that the app was easy to use and understand. Providers felt the alerts they received required refinement. Patients and providers agreed it would be beneficial for patients to report for longer than 4 weeks. Patients felt that the training they received was adequate but contained too much information for a single session. All patients found the symptoms tracked to be appropriate; providers suggested shortening the list. All patients understood how to use the app for weekly reporting but had confusion about using it ad hoc. Providers felt the ad hoc feature could be removed. Neither patients nor providers viewed the in-app data reports but agreed on their potential value. Patients reported benefitting from symptom reporting through increased awareness of their symptoms. Clinic staff reported that app alerts were too numerous and redundant. They had difficulty responding to alerts within their existing workflow, partially because the data were not integrated into the electronic medical record system. Conclusions: Overall, the intervention was found to be acceptable and appropriate for patients with RRMM. Points of friction integrating the intervention into the clinic workflow were identified. Clinic staff provided recommendations for addressing these issues. Once such modifications are implemented, ePRO data from patients with RRMM could be used to inform and improve clinical research and care. This study underlines the importance of an iterative approach to implementation that includes all stakeholders in order to ensure successful adoption. SN - 2561-326X UR - http://formative.www.mybigtv.com/2020/11/e18982/ UR - https://doi.org/10.2196/18982 UR - http://www.ncbi.nlm.nih.gov/pubmed/33200997 DO - 10.2196/18982 ID - info:doi/10.2196/18982 ER -