Unleashing the potential of eHealth in outpatient cancer care for patients undergoing immunotherapy—a quantitative study considering patients’ needs and current healthcare challenges

Frontiers in Digital Health, vol. 6, pp. 1414442

Abstract

Background: The use of online information and communication is globally increasing in the healthcare sector. In addition to known benefits in other medical fields, possible specific potentials of eHealth lie in the monitoring of oncological patients undergoing outpatient therapy. Specifically, the treatment with immune checkpoint inhibitors (ICI) requires intensive monitoring due to various possible negative side effects. The present study explores cancer patients' perspectives on eHealth and demonstrates how eHealth applications, from the patients' point of view, can contribute to further improving outpatient immunotherapy. Methods and findings: Our multicenter study was executed at the university hospitals in Bonn and Aachen. A structured questionnaire was distributed to patients receiving outpatient immunotherapy. Contents addressed were (1) the patients' attitude towards eHealth applications, (2) the use of modern information and communications technologies (ICT) in (2a) everyday life and (2b) health-related information search including eHealth literacy, (3) the use of internet-enabled devices as well as (4) socio-demographic data. 164 patients were included in the study, of whom 39.0% were female and 61.0% male and the average age was 62.8 years. Overall, there was a high distribution of internet-enabled devices for everyday use and a great interest in integrating eHealth applications into outpatient immunotherapy. The assessment of eHealth potentials significantly depended on age. The younger participants demonstrated a broader use of modern ICT and a higher affinity for its use in outpatient immunotherapy. In some aspects, level of education and gender were also relevant factors influencing the patients' view on eHealth. Conclusion: This study demonstrates the potential for further integration of eHealth applications into outpatient immunotherapy from the patients' perspective. It indicates a dependency on age and educational level for the further integration of eHealth into patient care in oncology. Due to particular patient needs regarding age, level of education, gender and other subgroups, specific education and training as well as target-group specific digital health interventions are necessary to fully utilize the potentials of eHealth for outpatient immunotherapy. Future studies are required to specifically address target-group specific usability of eHealth applications and eHealth literacy, as well as to address information security and data protection.

Authors 10

1. Tobias A.W. Holderried corresponding

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Center for Integrated Oncology (CIO) ABCD, Aachen Bonn Cologne Düsseldorf, Germany

   Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany

2. Izabela Stasik

   University Hospital Bonn

   Affiliation as printed

   Department of Ophthalmology, University Hospital Bonn, Bonn, Germany

3. Marie‐Therese Schmitz

   University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

   Affiliation as printed

   Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany

4. Friederike Schmitz

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Center for Integrated Oncology (CIO) ABCD, Aachen Bonn Cologne Düsseldorf, Germany

   Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany

5. Leonie Stauß

   University of Tübingen · Universitätsklinikum Tübingen · University of Hohenheim

   Affiliation as printed

   Department of Medical Strategy, Process- and Quality Management, Tuebingen University Hospital, Tuebingen, Germany

   Institute of Health Care and Public Management, University of Hohenheim, Stuttgart, Germany

6. Dirk Skowasch

   University Hospital Bonn

   Affiliation as printed

   Department of Medicine II, University Hospital Bonn, Bonn, Germany

7. Jennifer Landsberg

   University Hospital Bonn

   Affiliation as printed

   Department of Dermatology, University Hospital Bonn, Bonn, Germany

8. Matthias C. Schmid

   University Hospital Bonn · Institut für Medizinische Biometrie, Informatik und Epidemiologie

   Affiliation as printed

   Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University Hospital Bonn, Bonn, Germany

9. Peter Brossart

   University of Bonn · University Hospital Bonn

   Affiliation as printed

   Center for Integrated Oncology (CIO) ABCD, Aachen Bonn Cologne Düsseldorf, Germany

   Department of Oncology, Hematology, Immuno-Oncology and Rheumatology, University Hospital Bonn, Bonn, Germany

10. Martin Holderried

    University of Tübingen · Universitätsklinikum Tübingen · University of Hohenheim

    Affiliation as printed

    Department of Medical Strategy, Process- and Quality Management, Tuebingen University Hospital, Tuebingen, Germany

    Institute of Health Care and Public Management, University of Hohenheim, Stuttgart, Germany

    eHealth Research Group, Department of Otolaryngology-Head and Neck Surgery, Tuebingen University Hospital, Tuebingen, Germany