Development of an Educational Mobile Application for Patients Undergoing Radiation Therapy: Results of a Pilot Study to Understand Patient and Physician Needs

Purpose: Radiation education and information regarding side effect management can be difficult for patients to remember, causing them to feel overwhelmed and disempowered, with potential impact on outcomes. We developed a mobile application intended to be a more convenient and accessible educational resource for patients. This study sought to perform an educational needs assessment in patients to guide the design of the application, and to subsequently obtain physician perceptions of the beta-version of the application.

Methodology: As part of an IRB-approved study, patients undergoing radiation treatment were invited to complete an investigator-developed needs assessment. Patients were queried on symptoms experienced during radiation, treatments for their symptoms, education topics of interest, preferred sources of education, and interest in an educational mobile application. Subsequently, radiation oncologists were invited to participate in an IRB-approved prospective pilot of the application via email and social media. After testing, radiation oncologists were queried through an anonymous online survey about their opinions of the application. Items from both surveys were tabulated in summary statistics. Relationships between respondent demographics and survey responses were analyzed by univariate logistic regression.

Results: Sixty patients completed the educational needs assessment. Median age was 63.5 years (range 25-86). Thirty-eight (63.3%) were male. Thirty-two (53.3%) were non-Hispanic white, twelve (20.0%) were Hispanic white, and ten (16.7%) were Asian. The most preferred medium of education was through a physician (55, 91.7%). Patients were most interested in learning about long-term effects of radiation (32, 53.3%), how radiation works (28, 46.7%) and management of side effects (21, 35.0%). Fifteen patients (25.0%) reported being “very interested” in a mobile application and sixteen (26.7%) reported being “somewhat interested”. Patients younger than 60 years old were more likely to express interest in an application (OR: 4.79; p=0.008), while patients younger than 50 years old were more likely to be “very interested” (OR: 8.69, p=0.002).
Thirty-four radiation oncologists downloaded the application and 24 completed the online survey. Nineteen (79.2%) were younger than 40 years old, 14 (58.3%) were attending physicians, and 16 (66.6%) practiced at an academic practice. Twenty-one (87.5%) would recommend the application to their patients, 19 (79.2%) thought it would appeal to their patients, and 23 (95.8%) thought it would help patients. Twenty-one (87.5%) thought it would improve patient understanding of radiation, 20 (87.5%) thought it would improve patient engagement, 22 (91.7%) thought it would help patients remember to use essential products, and 23 (95.8%) thought it would empower patients to be involved in symptom management.

Conclusions: Based on the patient educational needs assessment and the physician pilot, our application appears to be a potential valuable means of improving education available to patients. Our application, with inclusion of feedback from patient and physician surveys, warrants further evaluation in a planned pilot in patients.

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