Using mHealth to improve palliative care at home

30th August 2021

Mobile health (mHealth) provides an opportunity to use internet coverage in low- and middle-income countries to improve palliative care access and quality.

A team of researchers from the Global Health Centre at the Cicely Saunders Institute aimed to design a mobile phone application (app) to enable or improve communication between family caregivers, community caregivers, and palliative care teams; to evaluate its acceptability, processes, and mechanisms of action; and to propose refinements.

A codesign process between a Project Advisory Group and collaborators in India, Uganda, and Zimbabwe was produced. The team then trained community and family caregivers to use the app to communicate patient-reported outcomes to their palliative care providers each week on a data dashboard. App activity was monitored, and qualitative in-depth interviews explored experience with the app and its mechanisms and impact.

149 caregivers participated and uploaded  837 assessments of patient-reported outcomes. These data were displayed to the palliative care team on an outcomes dashboard. The project found the app was well-received by caregivers and improved healthcare professionals’ understanding of patient symptoms and concerns.  The project also identified a need for better feedback to caregivers, and for better prioritisation of patients according to need.  It also identified a need for enhanced training and support to use the app, and for user-led recommendations for ongoing improvement.

The researchers concluded that an outcomes-focused app and data dashboard are highly acceptable to caregivers and health-care professionals. They are beneficial in identifying, monitoring, and communicating patient outcomes and in allocating staff resource to those most in need.

Harding R, Carrasco JM, Serrano-Pons J, Lemaire J, Namisango E, Luyirika E, Immanuel T, Paleri AK, Mathews L, Chifamba D, Mupaza L, Martínez CL, Zirimenya L, Bouësseau MC, Krakauer EL. Design and Evaluation of a Novel Mobile Phone Application to Improve Palliative Home-Care in Resource-Limited Settings. J Pain Symptom Manage. 2021 Jul;62(1):1-9. doi: 10.1016/j.jpainsymman.2020.09.045. Epub 2020 Nov 24. PMID: 33246073.