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Do mHealth apps targeting cancer live up to their promises?

By Jennifer Bresnick

When a physician says the word “cancer” to a patient, it’s usually one of the worst moments of that patient’s life.  Frightened about the future and unsure of what to do, he or she is increasingly likely to turn to a smartphone in order to gather information and seek support while battling the condition.  With hundreds of thousands of mHealth apps available for download, many of them purporting to specialize in a cancer patient or caregiver’s needs, it’s important to assess the quality and reliability of these programs in order to ensure patients are making good choices.  A recent study published in the Journal of Medical Internet Research calls into question the effectiveness and trustworthiness of these popular apps in an era of lax regulation and little certainty about the role of mHealth in patient care.

Despite the exploding popularity of apps to track weight, diet, blood sugar, or exercise, communicate with providers or disease-focused online communities, and remotely monitor conditions, there hasn’t been enough research on the usefulness of such tools, says lead author Jacqueline Lorene Bender, PhD, of the Princess Margaret Cancer Centre at University Health Network in Toronto.  Bender and her team reviewed literature on nearly 300 smartphone apps targeted towards providing educational information, raising awareness or research funding, and supporting disease management and early detection for conditions such as breast cancer.

More than half of apps did not provide details on organizational affiliations, although the majority of the remaining apps were endorsed or created by non-profits or medical institutions.  One quarter were promoted by for-profit commercial organizations.  The apps without attributions were more likely to cost money to download and use.   The stated purpose for most of the apps was to provide information or raise awareness about cancers.  Only 3.7% were intended to manage a disease, while just three of the programs allowed communication with or lessons from other cancer survivors.

In general, the apps reviewed by the study don’t take full advantage of the technical capabilities of a smartphone, Bender found.  There were few uses of wireless sensors, camera technologies, and automatic progress logging, in part because such features may now fall under FDA regulation that may be a barrier to mHealth development and distribution.

“Most of the apps included in this review relied on textual entry or touch screen completion of predetermined response options,” the study says.  “However, the effort involved in tracking one’s activities can be a significant barrier to adoption and sustained use. Only a few apps included features that could facilitate communication with the health care team. These were limited tools to identify and prioritize questions to ask your doctor and journaling apps to take notes during medical appointments.”

Other shortcomings included a lack of social media integration that can allow patients and caregivers to find support among fellow sufferers of a disease.  “Most diabetes apps that claimed to include social media features only provided a link to the device’s group page in social networking sites such as Twitter and Facebook,” Bender notes.  “Online health communities have repeatedly demonstrated their value in bringing together cancer patients and survivors to exchange information and support.  Nearly 30 years of research has consistently demonstrated that they have a powerful effect on physical and mental health and may extend survival.”

The study asserts that there is a need for greater oversight and regulation of apps if mHealth is to provide the maximum possible benefit to cancer patients.  “Currently lacking is a synthesis of this information for consumers, reporting standards for app store descriptions, and a set of criteria to aid consumers in selecting health apps,” the report concludes. “This information could be beneficial to developers, funders, and health professionals as well, and may improve the development of future apps and stimulate work in neglected areas.”

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