Mobile monitoring of outpatients during cancer therapy becomes possible through technological advancements. This study leveraged a new remote patient monitoring app for in-between systemic therapy sessions. Patients' evaluation showed that the handling is feasible. Clinical implementation must consider an adaptive development cycle for reliable operations.
Background: Outpatient treatments in oncology are increasing, including targeted therapies. The implementation of remote patient monitoring (RPM) between therapy sessions has the potential to enhance patient care and therapy outcomes in the future. Objective: This pilot study assessed the feasibility of a new, app-based RPM system (bwHealthApp) by capturing patient reported outcomes (PRO) and vital parameters using a wrist- or in-ear-worn wearable. The study examined adherence, acceptance and satisfaction, as well as the differences between the two types of wearables. Methods: Outpatients with gastrointestinal cancer receiving systemic therapies were invited to use and evaluate the bwHealthApp system for one month. The system was set up as an Android smartphone application to assess electronic patient reported outcomes (ePRO) and connect wearables for continuous vital sign measures. A wrist wearable (Beurer AS99) measured activity and heart rate, an in-ear wearable (Cosinuss Two) heart rate, oxygen saturation and temperature. The data was synchronized remotely to a web client. Outpatients were randomly assigned to the wrist (n=17) or in-ear wearable (n=14). At the beginning, middle and end of the study patients (n=31) completed questionnaires on various feasibility aspects. Adherence to ePRO and wearable use, acceptance and satisfaction, the wearable data quantity and quality as well as the wearable differences were evaluated. Results: The mean adherence to the bwHealthApp including dropouts was 45% (449/971 days) for ePRO and 59% (593/971 days) for wearable use. The system was most frequently used during everyday activities. Over half of the participants were satisfied with the bwHealthApp (18/30, 60%) and could imagine a further use (21/30, 70%). 70% (21/30) rated the use of the system as easy. Participants recorded more than 20 million wearable measures. 29% (84,688/355,764) of temperature values and 33% (21,247/88,005) of oxygen saturation values were measured outside the physiological range. For heart rate, the mean percentage was 10% (29,370/327,559, in-ear) and 11% (49,403/543,528, wrist). The frequency of use of the two wearables showed no significant difference (t29=1.81, P=.08). The wrist wearable scored significantly better than the in-ear wearable in terms of wearing comfort (t28=-11.17, P=.03). Conclusions: The bwHealthApp pilot study demonstrates the feasibility of RPM via a mobile app and wearable devices during outpatient systemic cancer therapy, including targeted therapies. The adherence level was moderate, and patients were generally satisfied with the system, although the wrist wearable received a higher rating. The system's functionality may be enhanced through the integration of additional wearables. The pilot study serves as a foundational framework for long-term assessments, examining RPM and clinical data to improve cancer treatments.