Mobile Phone App–Based Pulmonary Rehabilitation for Chemotherapy-Treated Patients With Advanced Lung Cancer: Pilot Study

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Abstract

Background

Advanced lung cancer patients often have chronic lung disease with reduced exercise capacities and various symptoms leading to altered quality of life (QoL). No studies have assessed pulmonary rehabilitation (PR) employing a mobile app and an Internet of Things device in advanced lung cancer patients undergoing chemotherapy.

Objective

This study aimed to determine the feasibility and efficacy of smartphone app–based PR on exercise capacity, symptom management, and QoL in patients with advanced lung cancer undergoing chemotherapy.

Methods

A total of 100 patients were recruited in a prospective, single-arm intervention study using a smartphone app–based PR program for 12 weeks. Exercise capacity (6-min walking distance, 6MWD), QoL, symptom scale scores, and distress indexes were investigated.

Results

A total of 90 patients completed the PR program. The most common cause of drop out was hospitalization because of cancer progression. After PR, there was significant improvement in the 6MWD; 380.1 m (SD 74.1) at baseline, 429.1 m (SD 58.6) at 6 weeks ( P<.001), and 448.1 m (SD 50.0) at 12 weeks ( P<.001). However, the dyspnea scale score showed no significant improvement in the patients overall, but there was a trend for improvement in those with a stable tumor response ( P=.07). Role ( P=.02), emotional ( P<.001), and social functioning ( P=.002) scale scores showed significant improvement after PR. Symptom scale scores for fatigue ( P<.001), anorexia ( P=.047), and diarrhea ( P=.01) also showed significant improvement. There was significant improvement in depression ( P=.048) and anxiety ( P=.01), whereas there was no significant change in QoL ( P=.06) and severity of pain ( P=.24).

Conclusions

Smartphone app–based PR represents an effective and feasible program to improve exercise capacity and to manage symptoms and distress in patients with advanced lung cancer who are undergoing chemotherapy.

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Is Open Access

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Ji Young Park, Seung-Hun Jang (2016)

Lung cancer causes the most cancer deaths in Korea. Although the smoking rate has begun to decrease, the prevalence of lung cancer is still increasing. We reviewed the national lung cancer registry data and the data published about lung cancer in Korea. In 2012, the crude incidence rate of lung cancer was 43.9 per 100,000. The age-standardized mortality rate of lung cancer was 19.8 per 100,000. The 5-year relative survival rate for lung cancer was 11.3% from 1993 to 1995 and increased to 21.9% in the period from 2008 to 2012. Lung cancer occurring in never-smokers was estimated to increase in Korea. Adenocarcinoma is steadily increasing in both women and men and has replaced squamous cell carcinoma as the most common type of lung cancer in Korea. In patients with adenocarcinoma, the frequency of EGFR mutations was 43% (range, 20%–56%), while that of the EMK4-ALK gene was less than 5%.

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Author and article information

Contributors

Chang Min Choi:

Department of Pulmonary and Critical Care Medicine, Asan Medical CenterUniversity of Ulsan College of MedicineSongpa–gu88 Olympic-ro 43-gilSeoul, 05505Republic of Korea82 2 3010 590282 2 3010 6968ccm9607@gmail.com

ORCID: http://orcid.org/0000-0002-2881-4669

Journal

Journal ID (nlm-ta): JMIR Mhealth Uhealth

Journal ID (iso-abbrev): JMIR Mhealth Uhealth

Journal ID (publisher-id): JMU

Title: JMIR mHealth and uHealth

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2291-5222

Publication date Collection: February 2019

Publication date (Electronic): 04 February 2019

Volume: 7

Issue: 2

Electronic Location Identifier: e11094

Affiliations

[1 ] Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea

[2 ] Department of Outpatient Nursing, Asan Medical Center Seoul Republic of Korea

[3 ] Department of Oncology, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea

[4 ] Department of Thoracic and Cardiovascular Surgery, Asan Medical Center University of Ulsan College of Medicine Seoul Republic of Korea

[5 ] Life Semantics Corp Seoul Republic of Korea

Author notes

Corresponding Author: Chang Min Choi ccm9607@ 123456gmail.com

Author information

Sojung Park http://orcid.org/0000-0002-2731-8188

Ji Youn Kim http://orcid.org/0000-0001-8354-1838

Jae Cheol Lee http://orcid.org/0000-0001-5963-0259

Hyeong Ryul Kim http://orcid.org/0000-0002-6691-7693

Seungjae Song http://orcid.org/0000-0002-6963-9123

Hee Kwon http://orcid.org/0000-0001-9910-1888

Wonjun Ji http://orcid.org/0000-0001-7164-2770

Chang Min Choi http://orcid.org/0000-0002-2881-4669

Article

Publisher ID: v7i2e11094

DOI: 10.2196/11094

PMC ID: 6378551

PubMed ID: 30714943

SO-VID: 1fa1de80-86b2-421c-aca8-2c83eca41c74

Copyright © ©Sojung Park, Ji Youn Kim, Jae Cheol Lee, Hyeong Ryul Kim, Seungjae Song, Hee Kwon, Wonjun Ji, Chang Min Choi. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 04.02.2019.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/.as well as this copyright and license information must be included.

History

Date received : 19 May 2018

Date revision requested : 3 September 2018

Date revision received : 23 October 2018

Date accepted : 10 November 2018

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