Zusammenfassung
Hintergrund
Die krankheits- und behandlungsbedingten Belastungen von Krebserkrankungen gehen in der Regel mit deutlichen Beeinträchtigungen der Lebensqualität der Betroffenen einher. Durch die starke Verbreitung des Internets in deutschen Haushalten stellen onkologische E‑Health-Angebote eine schnelle und einfach zugängliche mögliche Quelle der Unterstützung für Patienten und Angehörige dar. Angebote für Behandler umfassen z. B. Informationsportale, die Behandler auf die Bedürfnisse von Krebspatienten vorbereiten. Die Zukunft von onkologischen E‑Health Angeboten scheint in der Entwicklung von Angeboten für das Smartphone zu liegen.
Ziel
Die Autoren beschreiben E‑Health-Angebote in der Onkologie, v. a. hinsichtlich Form und Inhalt, Inanspruchnahme und Wirksamkeit.
Diskussion/Schlussfolgerung
In der Literatur ist eine große Anzahl von Studien zu finden, die Prozess und Outcome von E‑Health-Interventionen evaluieren. Jedoch wird weiterhin ein Bedarf für gut designte höherwertige RCTs (randomisierte kontrollierte Studien) konstatiert, unter anderem um genauere Aussagen zur Wirksamkeit der Angebote treffen zu können. Häufig berichtete Probleme der E‑Health-Angebote sind hohe Dropout-Raten und ein Nachhohlbedarf bei der bisher weitgehend fehlenden Implementierung der in Studien erprobten Ansätze in die Versorgungspraxis. Das Einbeziehen von potenziellen Zielgruppen in den Entwicklungsprozess der Angebote könnte hilfreich sein, um das Auftreten von hohen Dropout-Raten und Usability-Problemen zu vermindern und sicherzustellen, dass die Angebote dem Bedarf der Patienten entsprechen.
Abstract
Background
The disease and treatment-related burdens of cancer are usually associated with a significant decrease in the quality of life of those affected. Due to the widespread use of the Internet in German households, oncological eHealth offers are a quick and easily accessible source of healthcare support for patients and their relatives. Programs for healthcare professionals include, e. g. information portals that prepare clinicians for the needs of cancer patients. The development of smartphone Apps seems to be the most promising concept for future eHealth programs.
Objective
The article describes eHealth programs in oncology, especially with respect to form and content, utilization and effectiveness.
Discussion/conclusion
Many studies in the literature have evaluated the process and outcome of eHealth interventions; however, there continues to be a need for well-designed randomized controlled trials (RCTs) to be able to make more accurate statements about the effectiveness of the support programs. Frequently reported problems with eHealth programs are high drop-out rates and better implementation of study-proven approaches into the daily healthcare system. Including potential stakeholders in the program development process could be helpful in reducing the high drop-out rates and usability issues and ensuring that offers match patients’ needs.
Literatur
Aaronson NK, Mattioli V, Minton O et al (2014) Beyond treatment – psychosocial and behavioural issues in cancer survivorship research and practice. EJC Suppl 12:54–64
Aujoulat I, D’Hoore W, Deccache A (2007) Patient empowerment in theory and practice: polysemy or cacophony? Patient Educ Couns 66:13–20. https://doi.org/10.1016/j.pec.2006.09.008
Borosund E, Cvancarova M, Ekstedt M et al (2013) How user characteristics affect use patterns in web-based illness management support for patients with breast and prostate cancer. J Med Internet Res 15:e34. https://doi.org/10.2196/jmir.2285
Castleton K, Fong T, Wang-Gillam A et al (2011) A survey of Internet utilization among patients with cancer. Support Care Cancer 19:1183–1190. https://doi.org/10.1007/s00520-010-0935-5
Charnock D, Shepperd S, Needham G et al (1999) DISCERN: an instrument for judging the quality of written consumer health information on treatment choices. J Epidemiol Community Health 53:105–111
Christensen H, Griffiths KM, Farrer L (2009) Adherence in internet interventions for anxiety and depression. J Med Internet Res 11:e13. https://doi.org/10.2196/jmir.1194
Corboy D, McLaren S, Jenkins M et al (2014) The relationship between geographic remoteness and intentions to use a telephone support service among Australian men following radical prostatectomy. Psychooncology 23:1259–1266
De Vries H, Brug J (1999) Computer-tailored interventions motivating people to adopt health promoting behaviours: introduction to a new approach. Patient Educ Couns 36:99–105
Eysenbach G (2005) The law of attrition. J Med Internet Res 7:e11. https://doi.org/10.1002/pon.3559
Frost J, Okun S, Vaughan T et al (2011) Patient-reported outcomes as a source of evidence in off-label prescribing: analysis of data from PatientsLikeMe. J Med Internet Res 13:e6. https://doi.org/10.2196/jmir.1643
Frost J, Vermeulen IE, Beekers N (2014) Anonymity versus privacy: selective information sharing in online cancer communities. J Med Internet Res 16:e126. https://doi.org/10.2196/jmir.2684
Girgis A, Delaney GP, Arnold A et al (2016) Development and feasibility testing of PROMPT-care, an eHealth system for collection and use of patient-reported outcome measures for personalized treatment and care: a study protocol. JMIR Res Protoc 5:e227. https://doi.org/10.2196/resprot.6459
Glynn LG, Hayes PS, Casey M et al (2014) Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. Br J Gen Pract 64:e384–e391. https://doi.org/10.3399/bjgp14X680461
Golsteijn RHJ, Bolman C, Volders E et al (2017) Development of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: OncoActive. BMC Cancer 17:446. https://doi.org/10.1186/s12885-017-3397-z
Halleberg Nyman M, Frank C, Langius-Eklof A et al (2017) Patients’ perspective on participation in care with or without the support of a smartphone app during radiotherapy for prostate cancer: qualitative study. JMIR Mhealth Uhealth 5:e107. https://doi.org/10.2196/mhealth.6829
Harder H, Holroyd P, Burkinshaw L et al (2017) A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment. J Cancer Surviv 11:732–742. https://doi.org/10.1007/s11764-017-0630-3
Hong Y, Pena-Purcell NC, Ory MG (2012) Outcomes of online support and resources for cancer survivors: a systematic literature review. Patient Educ Couns 86:288–296. https://doi.org/10.1016/j.pec.2011.06.014
Hoybye MT, Dalton SO, Deltour I et al (2010) Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study. Br J Cancer 102:1348–1354. https://doi.org/10.1038/sj.bjc.6605646
Johansen MA, Berntsen GK, Schuster T et al (2012) Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. Part 2: methodological quality and effects. J Med Internet Res 14:e126. https://doi.org/10.2196/jmir.2216
Johansen MA, Henriksen E, Horsch A et al (2012) Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. Part 1: state of the art. J Med Internet Res 14:e118. https://doi.org/10.2196/jmir.2214
Kaltenbaugh DJ, Klem ML, Hu L et al (2015) Using web-based interventions to support caregivers of patients with cancer: a systematic review. Oncol Nurs Forum 42:156–164. https://doi.org/10.1188/15.ONF.156-164
Kanera IM, Bolman CA, Willems RA et al (2016) Lifestyle-related effects of the web-based Kanker Nazorg Wijzer (cancer aftercare guide) intervention for cancer survivors: a randomized controlled trial. J Cancer Surviv 10:883–897. https://doi.org/10.1007/s11764-016-0535-6
Kanera IM, Willems RA, Bolman CA et al (2017) Long-term effects of a web-based cancer aftercare intervention on moderate physical activity and vegetable consumption among early cancer survivors: a randomized controlled trial. Int J Behav Nutr Phys Act 14:19. https://doi.org/10.1186/s12966-017-0474-2
Khalil GE (2012) When losing means winning: the impact of conflict in a digital game on young adults’ intentions to get protected from cancer. Games Health J 1:279–286. https://doi.org/10.1089/g4h.2012.0017
Klemm P, Hardie T (2002) Depression in internet and face-to-face cancer support groups: a pilot study. Oncol Nurs Forum 29:E45–E51. https://doi.org/10.1188/02.ONF.E45-E51
Koch W, Frees B (2016) Dynamische Entwicklung bei mobiler Internetnutzung sowie Audios und Videos: Ergebnisse der ARD/ZDF-Onlinestudie 2016. Media Perspekt 2016(9):418–437. https://doi.org/10.2196/jmir.2281
Kuijpers W, Groen WG, Aaronson NK et al (2013) A systematic review of web-based interventions for patient empowerment and physical activity in chronic diseases: relevance for cancer survivors. J Med Internet Res 15:e37. https://doi.org/10.2196/jmir.2281
Liebl P, Seilacher E, Koester MJ et al (2015) What cancer patients find in the internet: the visibility of evidence-based patient information – analysis of information on German websites. Oncol Res Treat 38:212–218. https://doi.org/10.1159/000381739
Lozano-Lozano M, Moral-Munoz JA, Galiano-Castillo N et al (2017) Designing BENECA m‑health APP, a mobile health application to monitor diet and physical activity in cancer survivors. Lect Notes Comput Sci. https://doi.org/10.1007/978-3-319-59147-6_6
Lu HY, Shaw BR, Gustafson DH (2011) Online health consultation: examining uses of an interactive cancer communication tool by low-income women with breast cancer. Int J Med Inform 80:518–528. https://doi.org/10.1016/j.ijmedinf.2011.03.011
Mayer DK, Terrin NC, Kreps GL et al (2007) Cancer survivors information seeking behaviors: a comparison of survivors who do and do not seek information about cancer. Patient Educ Couns 65:342–350. https://doi.org/10.1016/j.pec.2006.08.015
Mcalpine H, Joubert L, Martin-Sanchez F et al (2015) A systematic review of types and efficacy of online interventions for cancer patients. Patient Educ Couns 98:283–295. https://doi.org/10.1016/j.pec.2014.11.002
Mccorkle R, Ercolano E, Lazenby M et al (2011) Self-management: enabling and empowering patients living with cancer as a chronic illness. Ca Cancer J Clin 61:50–62
Mitchell S, Heyden R, Heyden N et al (2011) A pilot study of motivational interviewing training in a virtual world. J Med Internet Res 13:e77
Moessner M, Bauer S (2017) E‑Mental-Health und internetbasierte Psychotherapie. Psychotherapeut 62:251–266. https://doi.org/10.1007/s00278-017-0198-4
Mosa AS, Yoo I, Sheets L (2012) A systematic review of healthcare applications for smartphones. Bmc Med Inform Decis Mak 12:67. https://doi.org/10.1186/1472-6947-12-67
Nghiem AZ, Mahmoud Y, Som R (2016) Evaluating the quality of internet information for breast cancer. Breast 25:34–37. https://doi.org/10.1016/j.breast.2015.10.001
Nijland N, Cranen K, Boer H et al (2010) Patient use and compliance with medical advice delivered by a web-based triage system in primary care. J Telemed Telecare 16:8–11. https://doi.org/10.1258/jtt.2009.001004
Norman CD, Skinner HA (2006) eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res 8:e9. https://doi.org/10.2196/jmir.8.2.e9
Peters K, Kayali F, Reithofer A et al (2015) Serious game scores as health condition indicator for cancer patients. Stud Health Technol Inform 210:892–896
Prasad SM, Eggener SE, Lipsitz SR et al (2014) Effect of depression on diagnosis, treatment, and mortality of men with clinically localized prostate cancer. J Clin Oncol 32:2471–2478. https://doi.org/10.1200/JCO.2013.51.1048
Rains SA, Young V (2009) A Meta-analysis of research on formal computer-mediated support groups: examining group characteristics and health outcomes. Hum Commun Res 35:309–336. https://doi.org/10.1111/j.1468-2958.2009.01353.x
Sajid MS, Iftikhar M, Monteiro RS et al (2008) Internet information on colorectal cancer: commercialization and lack of quality control. Colorectal Dis 10:352–356. https://doi.org/10.1111/j.1463-1318.2007.01316.x
Sanchez M, Rabin B, Gaglio B et al (2013) A systematic review of eHealth cancer prevention and control interventions: new technology, same methods and designs? Transl Behav Med 3:392–401 https://doi.org/10.1007/s13142-013-0224-1
Shaw BR, Hawkins R, Arora N et al (2006) An exploratory study of predictors of participation in a computer support group for women with breast cancer. Comput Inform Nurs 24:18–27. https://doi.org/10.1097/00024665-200
Shaw T, McGregor D, Sinclaire S et al (2014) E‑learning portal for professional development in cancer care. Educ Train 56:165–178 https://doi.org/10.1108/ET-11-2012-0113
Van Eenbergen MC, Van De Poll-Franse LV, Heine P et al (2017) The impact of participation in online cancer communities on patient reported outcomes: systematic review. JMIR Cancer 3:e15 https://doi.org/10.2196/cancer.7312
Van Gemert-Pijnen JE, Nijland N, Van Limburg M et al (2011) A holistic framework to improve the uptake and impact of eHealth technologies. J Med Internet Res 13:e111. https://doi.org/10.2196/jmir.1672
Ventura F, Ohlen J, Koinberg I (2013) An integrative review of supportive e‑health programs in cancer care. Eur J Oncol Nurs 17:498–507. https://doi.org/10.1016/j.ejon.2012.10.007
Willems RA, Bolman CA, Mesters I et al (2015) The Kanker Nazorg Wijzer (cancer aftercare guide) protocol: the systematic development of a web-based computer tailored intervention providing psychosocial and lifestyle support for cancer survivors. BMC Cancer 15:580. https://doi.org/10.1186/s12885-015-1588-z
Willems RA, Bolman CA, Mesters I et al (2017) Short-term effectiveness of a web-based tailored intervention for cancer survivors on quality of life, anxiety, depression, and fatigue: randomized controlled trial. Psychooncology 26:222–230. https://doi.org/10.1002/pon.4113
Wolf JA, Moreau JF, Akilov O et al (2013) Diagnostic inaccuracy of smartphone applications for melanoma detection. JAMA dermatology 149:422–426 https://doi.org/10.1001/jamadermatol.2013.2382
Förderung
Die Erstellung des Beitrags wurde mit Mitteln der Damp-Stiftung gefördert.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Interessenkonflikt
L. Lange, H. Schulz und C. Bleich geben an, dass kein Interessenkonflikt besteht.
Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.
Rights and permissions
About this article
Cite this article
Lange, L., Schulz, H. & Bleich, C. E-Health-Angebote in der Onkologie. Onkologe 24, 406–410 (2018). https://doi.org/10.1007/s00761-018-0348-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00761-018-0348-5