Table 2.

Functionality of applications, inclusion criteria, outcome measures and results of studies testing mHealth applications for patients with cancer

Author (year)	Name & function of application	Inclusion criteria	Outcome measures	Results
Aljabri D (2018)	Existing patient portal	Adult patient admitted to hospital with cancer as a primary or secondary diagnosis	Provider-reported, in-hospital adverse event; post-discharge emergency department visits and unplanned readmissions within 30 days; satisfaction by Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey.	Increased readmission rates among active adaptors of the patient portal. Self-management knowledge scores were higher among adopters vs non-adopters (univariate analyses only)
Basch E (2018)	STAR (Symptom Tracking and Reporting) Web-based interface for self-reporting of common symptoms associated with cancer treatment	Patients with metastatic breast, genitourinary, gynaecologic or lung cancers receiving chemotherapy stratified for experience with computers	Health-related quality of life (HRQoL measured by EQ-5D); emergency room visits, hospitalizations, survival.	Patient in the intervention group experienced less decline of HRQoL less frequent admissions to the emergency room, less hospitalization and remained on chemotherapy longer. Effects on HRQoL limited to the computer-experienced subgroup.
Berry D (2015)	Self-reported online assessment of cancer symptoms: Application facilitating patient self-monitored symptoms, education and coaching on how to report worries to clinicians.	Adult patients, any type of cancer or stage, about to start a new treatment for cancer.	Symptom distress	Fatigue, pain and physical function issues were reported significantly more often by patients in the intervention group.
Denis F (2014)	Sentinel follow-up questionnaire. Email alert sent to oncologist if patient reports red flag symptoms.	Lung cancer patients after undergone surgical excision, complete response or detectable but non-progressive lung cancer.	Compliance, easiness, anxiety and performances of web application for detecting cancer relapse	Relapse detection was on average 5 weeks earlier using sentinel follow-up. Reported better relationship with oncologist and reduced anxiety about follow-up.
Foley N (2016)	Application containing basic aetiology of breast cancer, treatment and surgical intervention information.	Female adult pre-operative patients with breast cancer	Anxiety and depression scores prior and post intervention	Higher anxiety levels in intervention groups.
Fortier M (2016)	Pain buddy Avatar-guided tablet application including a symptom diary, communication tool and coping strategies for symptom management. Triggers to healthcare providers for severe symptoms.	Paediatric patients aged 8–18, diagnosed with cancer, undergoing outpatient cancer treatment. One parent/guardian also invited to participate. No cognitive or developmental delay.	Feasibility, symptom frequency and compliance	Symptoms were reported and recommended coping strategies utilized. Only 4% of symptoms would have triggered an alert to healthcare professionals, most of these for pain. Good compliance and user satisfaction.
Golsteijn RHJ (2018)	OncoActive Computer-tailored physical activity program Providing personalized feedback with printed materials.	Patients and survivors with prostate and colorectal cancer from 17 hospitals throughout the Netherlands	Questionnaires for self-reported physical activity, fatigue, distress and quality of life. Actigraph for measurement of activity	Participants in the intervention group increased self-reported activity and improved physical functioning, fatigue and depression at 6 months.
Jibb LA (2017)	Pain squad+ 22-item questionnaire to assess pain. Real-time reporting. Patients were contacted if they reported frequent pain and information was available from the application on how best to manage the pain.	Patients aged 12–28, undergoing cancer treatment, at least 2 months from diagnosis. Patients reported pain of 3/10 at least once in week prior to recruitment.	Primary: feasibility; secondary: effectiveness: pain intensity, pain interference, health-related quality of life, self-efficacy	Improvements in pain intensity and health-related quality of life. Satisfactory acceptability with good adherence by those who completed the study.
Kanera I (2017)	Web-based self-reporting questionnaires and modules providing education about diet, smoking cessation, physical activity, anxiety, depression and fatigue.	Adult patients who had completed primary cancer treatment at least 4 weeks prior. Patients with recurrent cancer and severe medical, psychiatric or cognitive diseases excluded.	Physical activity, vegetable consumption	Sustained increase in physical activity in the intervention group. Increased vegetable consumption in the intervention group, but results not sustained to 12 months.
Kolb NA (2018)	SymptomCare@Home Daily symptom monitoring by telephone. Intervention group with automated telephone delivered self-care strategies and alert of nurse practitioner for poor symptom control.	Patients beginning chemotherapy with taxane/platinum therapies as a part of a larger trial.	Severity, distress and impact on activity of neuropathic pain	Patients in the intervention group had significantly fewer days with moderate and severe symptoms, fewer days of symptom distress and a trend towards less activity interference.
Rosen KD (2018)	Headspace Commercially available mindfulness application	Women aged 25 or more within 5 years post breast cancer diagnosis	Functional Assessment of Cancer Therapy – Breast (FACT-B), mindfulness, and pain assessments at baseline, during 8 week intervention and at 12 weeks.	Participants in the intervention group reported higher quality of life with FACT-B and higher dispositional mindfulness.
Sundberg K (2017)	Interaktor Symptom questionnaire focusing on frequency and distress level, responses triggered red or yellow alerts to an oncology nurse.	Adults with localized prostate cancer, eligible for curative radiotherapy, considered physically, psychologically and cognitively fit enough to take part.	Symptoms and health-related quality of life	No difference within groups in symptoms over time but improvements between intervention and control group. In the control group after radiotherapy worse emotional functioning with more fatigue, nausea, insomnia and urinary symptoms.
Smith SK (2016)	Cancer distress coach PTSD symptom checker with advice on managing symptoms and information on reliable sources of support	Lymphoma, breast or prostate cancer patients, 19 years or older, active PTSD symptoms	PTSD symptoms, distress, self-efficacy, feasibility, acceptability and perceived usefulness.	The majority of patients found the application helpful. Statistically significant reduction is PCL-S score for PTSD symptoms after using the app. No change in self efficacy.
Soto-Pere-De-Celis E (2018)	Accelerometer & application Remote monitoring of daily steps, before and during chemotherapy, with a trigger of > 15% drop in baseline activity as an indicator of potential chemotoxicity.	Patients aged >65 years, any solid cancer, chemotherapy as first line in either metastatic or recurrent cancer.	Primary: feasibility; secondary: association of level of activity with grade of chemotherapy toxicity	High acceptability of application to patients despite limited interaction with mobile technology and low educational status. Association of low step counts with grade 3 toxicity.
Sundberg K (2017)	Interaktor Symptom questionnaire focusing on frequency and distress level, responses triggered red or yellow alerts to an oncology nurse.	Adults with localized prostate cancer, eligible for curative radiotherapy, considered physically, psychologically and cognitively fit enough to take part.	Symptoms and health related quality of life	No difference within groups in symptoms over time but improvements between intervention and control group. In the control group after radiotherapy worse emotional functioning with more fatigue, nausea, insomnia and urinary symptoms.
Uhm K (2017)	Pedometer and smartphone app which monitored a prescribed 12-week exercise programme. Quality of life assess at baseline and 12 weeks.	Histologically confirmed breast cancer, age 20 to 70 years, completion of primary cancer treatment including surgery, chemotherapy and/or radiotherapy.	Activity measurements, self-reported physical activity, quality of life	Physical function, physical activity, and Quality of Life scores were equally improved in both groups.
Wheelock A (2014)	SIS-NET Three-monthly web-based self-reported symptoms. Remote assessment by a nurse practitioner.	Patients with breast cancer after completion of acute treatment or any clinical trial adjuvant treatment (6 months post chemo, 3 months post hormonal therapy or surgery)	Time between symptom reporting and evaluation by healthcare professionals, use of healthcare resources.	Only 74% of symptoms addressed within less than 3 days. Significantly more symptoms reported by patients in the intervention group. No difference in oncology-related appointments, physician visits or medical tests.
Zou Q (2018)	Telephone and WeChat application	Symptomatic adults with uterine myoma	Hamilton Anxiety Scale before and after treatment, Visual Analogue Scale for pain during the first 24 h after treatment.	Patients in the intervention group had less preoperative and postoperative anxiety, less postoperative pain and higher treatment satisfaction.