Real-time electronic patient evaluation of lymphedema symptoms, referral, and satisfaction: a cross-sectional study

Jennifer L Nahum; Mei R Fu; Joan Scagliola; Martha Rodorigo; Sandy Tobik; Amber Guth; Deborah Axelrod

doi:10.21037/mhealth-20-118

Real-time electronic patient evaluation of lymphedema symptoms, referral, and satisfaction: a cross-sectional study

Mhealth. 2021 Apr 20:7:20. doi: 10.21037/mhealth-20-118. eCollection 2021.

Authors

Jennifer L Nahum¹, Mei R Fu^{1

2}, Joan Scagliola³, Martha Rodorigo¹, Sandy Tobik¹, Amber Guth⁴, Deborah Axelrod⁴

Affiliations

¹ NYU Rory Meyers College of Nursing, New York, NY, USA.
² The Boston College William F. Connell School of Nursing, Chestnut Hill, MA, USA.
³ Director of Nursing, NYU Clinical Cancer Center, New York, NY, USA.
⁴ New York University School of Medicine, NYU Clinical Cancer Center, New York, NY, USA.

Abstract

Background: Lymphedema is a progressive and chronic illness. Early detection and treatment often lead to better clinical outcomes and improvement of patients' quality of life. Lymphedema symptoms can assist in detecting lymphedema. However, the use of patient-reported symptom evaluation is still limited in clinical practice. To address this gap in clinical practice, a metropolitan cancer center implemented an electronic patient evaluation of lymphedema symptoms (EPE-LE) to enable patients' real-time symptom report during patients' routine clinical visit while waiting to see their doctors in a waiting room. The purpose of this clinical project was to evaluate the usefulness of EPE-LE during patients' routine clinical visit.

Methods: A cross-sectional design was used. Participants were outpatient post-surgical breast cancer patients and clinicians who were involved in the EPE-LE implementation at a metropolitan cancer center of US. Data were collected during the three-month EPE-LE implementation, including patients' report of lymphedema symptoms, patient and clinician satisfaction, and referral to lymphedema specialists. Descriptive statistics were used for data analysis.

Results: During the three-month implementation, a total of 334 patients utilized the EPE-LE to report their lymphedema symptoms and 24 referrals to lymphedema specialists. Nearly all of the patients found that the EPE-LE was easy to use (91%) and that they were satisfied with the EPE-LE for reporting lymphedema symptoms (89%). The majority (70%) of patients reported that the EPE-LE helped them to learn about symptoms related to lymphedema and encouraged them to monitor their symptoms. All clinicians (100%) agreed that the use of the EPE-LE improved their lymphedema symptom assessment in post-surgical breast cancer patients; 75% reported that the EPE-LE increased their communication with patients related to lymphedema symptoms, 75% agreed they would recommend the EPE-LE for use at other cancer centers, and 75% reported that the information retrieved from the EPE-LE was helpful in evaluation of lymphedema.

Conclusions: The use of EPE-LE enhanced patients' real-time report of lymphedema symptoms, improved patient education on lymphedema symptoms, and helped clinicians for evaluation of lymphedema. The use of EPE-LE is an example how to implement evidence-based research into clinical practice that provides benefits for both patients and clinicians.

Keywords: Real-time; detection; electronic tablet; evaluation; lymphedema; symptom.