P29 A smartphone application to monitor nausea in pediatric cancer patients during chemotherapy

BackgroundNausea is a common and distressing side effect for children in chemotherapy. Antiemetic recommendations are based on limited literature and prospective evaluation of antiemetic efficacy is required. Smartphone applications (apps) may collect patient-reported outcomes with precision and effectiveness1. We developed a smartphone app to track nausea in pediatric cancer patients during chemotherapy.MethodsMedical researchers, pediatric oncologists and software engineers worked synergistically in the development. We translated the validated Pediatric Nausea Assessment Tool to score nausea severity2. We conducted three rounds of patient-feedback and modification.ResultsThe app has a definition module where the child centers the attention to the concept of nausea. The child can then express nausea severity with four faces and the child’s own definition of nausea is incorporated in the question2. The app includes a notification system to ensure high response rates. All participants felt that the app was user-friendly, intuitive and that time spent was acceptable.ConclusionThe app is a user-friendly tool to assess nausea in pediatric cancer patients that can ease future pediatric antiemetic trials.ReferencesStone AA, Shiffman S, Schwartz JE, et al. Patient compliance with paper and electronic diaries. Control Clin Trials 2003 Apr;24(2):182–99.Dupuis LL, Taddio A, Kerr EN, et al. Development and validation of the pediatric nausea assessment tool for use in children receiving antineoplastic agents. Pharmacotherapy 2006;26:1221–31.Disclosure(s)Nothing to disclose

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Smartphone App to Self-Monitor Nausea During Pediatric Chemotherapy Treatment: User-Centered Design Process

JMIR mhealth and uhealth ◽

10.2196/18564 ◽

2020 ◽

Vol 8 (7) ◽

pp. e18564

Author(s):

Astrid Eliasen ◽

Mikkel Kramme Abildtoft ◽

Niels Steen Krogh ◽

Catherine Rechnitzer ◽

Jesper Sune Brok ◽

...

Keyword(s):

Design Process ◽

Response Rates ◽

Nausea And Vomiting ◽

Smartphone App ◽

User Centered Design ◽

Pediatric Cancer Patients ◽

Patient Reported ◽

User Friendly ◽

Nausea Severity ◽

User Centered

Background Nausea and vomiting are common and distressing side effects for children receiving chemotherapy. Limited evidence is available to guide antiemetic recommendations; therefore, prospective and reliable evaluation of antiemetic efficacy is needed. Smartphone apps can be used to effortlessly and precisely collect patient-reported outcomes in real time. Objective Our objective was to develop a smartphone app to monitor nausea and vomiting episodes in pediatric cancer patients aged 0 to 18 years and to test its usability and adherence to its use. Methods We used a user-centered design process and the evolutionary prototype model to develop and evaluate the app. Multidisciplinary group discussions and several rounds of patient feedback and modification were conducted. We translated the validated Pediatric Nausea Assessment Tool to assess nausea severity in children aged 4 to 18 years. The child’s own term for nausea was interactively incorporated in the nausea severity question, with response options expressed as 4 illustrative faces. Parent-reported outcomes were used for children aged 0 to 3 years. Reminders were sent using push notifications in order to ensure high response rates. Children aged 0 to 18 years who were undergoing chemotherapy were recruited from the Department of Pediatric Oncology at Copenhagen University Hospital Rigshospitalet to evaluate the app. Results The app’s most important function was to record nausea severity in children. After assistance from a researcher, children aged 4 to 18 years were able to report their symptoms in the app, and parents were able to report symptoms for their children aged 0 to 3 years. Children (n=20, aged 2.0-17.5 years) and their parents evaluated the app prospectively during a collective total of 60 chemotherapy cycles. They expressed that the app was user-friendly, intuitive, and that the time spent on data entry was fair. The response rates were on average 92%, 93%, and 80% for the day before, the first day of, and the next 3 days after chemotherapy, respectively. Researchers and clinicians were able to obtain an overview of the patient’s chemotherapy dates and responses through a secure and encrypted web-based administrative portal. Data could be downloaded for further analysis. Conclusions The user-friendly app could be used to facilitate future pediatric antiemetic trials and to refine antiemetic treatment during chemotherapy.

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The Pediatric Nausea Assessment Tool: French translation and face validity in Francophone-Canadian pediatric oncology patients

Canadian Oncology Nursing Journal ◽

10.5737/236880763116472 ◽

2021 ◽

Vol 31 (1) ◽

pp. 64-72

Author(s):

Anne Choquette ◽

Araby Sivananthan ◽

Annie Guillemette ◽

Erin O'Shaughnessy ◽

Martha Pinheiro-Maltez ◽

...

Keyword(s):

Cancer Patients ◽

Pediatric Cancer ◽

Rating Scales ◽

Assessment Tool ◽

Subjective Symptom ◽

Self Report ◽

Face Validity ◽

French Translation ◽

Pediatric Cancer Patients

Chemotherapy-induced nausea and vomiting (CINV) continue to negatively influence the quality of life of both adult and pediatric cancer patients (Dupuis et al., 2010; Farrell et al., 2013; Russo et al., 2014; Hinds et al., 2009; Sommariva et al., 2016). Vomiting and retching are symptoms that can be assessed objectively while nausea, a subjective symptom, is more difficult to quantify. Adult cancer patients can usually describe the severity of the nausea they feel using self-report visual analog or adjectival rating scales. Instruments such as the Multinational Association of Supportive Care in Cancer Antiemesis Tool (available from www.mascc.org) have been validated for this purpose and are recommended by experts in the field (Hesketh et al., 2015).

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Smartphone App to Self-Monitor Nausea During Pediatric Chemotherapy Treatment: User-Centered Design Process (Preprint)

10.2196/preprints.18564 ◽

2020 ◽

Author(s):

Astrid Eliasen ◽

Mikkel Kramme Abildtoft ◽

Niels Steen Krogh ◽

Catherine Rechnitzer ◽

Jesper Sune Brok ◽

...

Keyword(s):

Design Process ◽

Response Rates ◽

Nausea And Vomiting ◽

Smartphone App ◽

User Centered Design ◽

Pediatric Cancer Patients ◽

Patient Reported ◽

User Friendly ◽

Nausea Severity ◽

User Centered

BACKGROUND Nausea and vomiting are common and distressing side effects for children receiving chemotherapy. Limited evidence is available to guide antiemetic recommendations; therefore, prospective and reliable evaluation of antiemetic efficacy is needed. Smartphone apps can be used to effortlessly and precisely collect patient-reported outcomes in real time. OBJECTIVE Our objective was to develop a smartphone app to monitor nausea and vomiting episodes in pediatric cancer patients aged 0 to 18 years and to test its usability and adherence to its use. METHODS We used a user-centered design process and the evolutionary prototype model to develop and evaluate the app. Multidisciplinary group discussions and several rounds of patient feedback and modification were conducted. We translated the validated Pediatric Nausea Assessment Tool to assess nausea severity in children aged 4 to 18 years. The child’s own term for nausea was interactively incorporated in the nausea severity question, with response options expressed as 4 illustrative faces. Parent-reported outcomes were used for children aged 0 to 3 years. Reminders were sent using push notifications in order to ensure high response rates. Children aged 0 to 18 years who were undergoing chemotherapy were recruited from the Department of Pediatric Oncology at Copenhagen University Hospital Rigshospitalet to evaluate the app. RESULTS The app’s most important function was to record nausea severity in children. After assistance from a researcher, children aged 4 to 18 years were able to report their symptoms in the app, and parents were able to report symptoms for their children aged 0 to 3 years. Children (n=20, aged 2.0-17.5 years) and their parents evaluated the app prospectively during a collective total of 60 chemotherapy cycles. They expressed that the app was user-friendly, intuitive, and that the time spent on data entry was fair. The response rates were on average 92%, 93%, and 80% for the day before, the first day of, and the next 3 days after chemotherapy, respectively. Researchers and clinicians were able to obtain an overview of the patient’s chemotherapy dates and responses through a secure and encrypted web-based administrative portal. Data could be downloaded for further analysis. CONCLUSIONS The user-friendly app could be used to facilitate future pediatric antiemetic trials and to refine antiemetic treatment during chemotherapy.

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