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  <front>
    <journal-meta>
      <journal-id journal-id-type="publisher-id">IPROC</journal-id>
      <journal-id journal-id-type="nlm-ta">iproc</journal-id>
      <journal-title>Iproceedings</journal-title>
      <issn pub-type="epub">2369-6893</issn>
      <publisher>
        <publisher-name>JMIR Publications</publisher-name>
        <publisher-loc>Toronto, Canada</publisher-loc>
      </publisher>
    </journal-meta>
    <article-meta>
    <article-id pub-id-type="publisher-id">v4i2e11830</article-id>
    <article-id pub-id-type="pmid"/>
    <article-id pub-id-type="doi">10.2196/11830</article-id>
    <article-categories>
      <subj-group subj-group-type="heading">
        <subject>Abstract</subject>
      </subj-group>
      <subj-group subj-group-type="article-type">
        <subject>Abstract</subject>
      </subj-group>
    </article-categories>
    <title-group>
      <article-title>A Two-Arm Randomized Pilot Study to Evaluate the Impact of a Mobile Health App on Quality of Life in Patients on Oral Anti-Cancer Medications</article-title>
    </title-group>
    <contrib-group>
      <contrib contrib-type="editor">
        <name>
          <surname>Hale</surname>
          <given-names>Timothy</given-names>
        </name>
      </contrib>
    </contrib-group>
    <contrib-group>
      <contrib contrib-type="author" id="contrib1" corresp="yes">
      <name name-style="western">
        <surname>Fischer</surname>
        <given-names>Nils</given-names>
      </name>
      <xref rid="aff1" ref-type="aff">1</xref>
      <address>
        <institution>Partners Healthcare</institution>
        <institution>Partners Connected Health</institution>
        <addr-line>25 New Chardon Street</addr-line>
        <addr-line>Boston, MA, 02114</addr-line>
        <country>United States</country>
        <phone>1 978 407 1940</phone>
        <email>nfischer@partners.org</email>
      </address>  
      <xref rid="aff2" ref-type="aff">2</xref></contrib>
      <contrib contrib-type="author" id="contrib2">
        <name name-style="western">
          <surname>Agboola</surname>
          <given-names>Stephen</given-names>
        </name>
        <xref rid="aff1" ref-type="aff">1</xref>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib3">
        <name name-style="western">
          <surname>Palacholla</surname>
          <given-names>Ramya</given-names>
        </name>
        <xref rid="aff1" ref-type="aff">1</xref>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib4">
        <name name-style="western">
          <surname>Atif</surname>
          <given-names>Mursal</given-names>
        </name>
        <xref rid="aff1" ref-type="aff">1</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib5">
        <name name-style="western">
          <surname>Kvedar</surname>
          <given-names>Joseph</given-names>
        </name>
        <xref rid="aff1" ref-type="aff">1</xref>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
      <contrib contrib-type="author" id="contrib6">
        <name name-style="western">
          <surname>Jethwani</surname>
          <given-names>Kamal</given-names>
        </name>
        <xref rid="aff1" ref-type="aff">1</xref>
        <xref rid="aff2" ref-type="aff">2</xref>
      </contrib>
    </contrib-group>
    <aff id="aff1">
    <label>1</label>
    <institution>Partners Healthcare</institution>
    <institution>Partners Connected Health</institution>  
    <addr-line>Boston, MA</addr-line>
    <country>United States</country></aff>
    <aff id="aff2">
      <label>2</label>
      <institution>Harvard Medical School</institution>
      <addr-line>Boston, MA</addr-line>
      <country>United States</country>
    </aff>
    <author-notes>
      <corresp>Corresponding Author: Nils Fischer 
      <email>nfischer@partners.org</email></corresp>
    </author-notes>
    <pub-date pub-type="collection"><season>Jul-Dec</season><year>2018</year></pub-date>
    <pub-date pub-type="epub">
      <day>17</day>
      <month>09</month>
      <year>2018</year>
    </pub-date>
    <volume>4</volume>
    <issue>2</issue>
    <elocation-id>e11830</elocation-id>
    <!--history from ojs - api-xml-->
    <history>
      <date date-type="received">
        <day>6</day>
        <month>8</month>
        <year>2018</year>
      </date>
      <date date-type="accepted">
        <day>29</day>
        <month>8</month>
        <year>2018</year>
      </date>
    </history>
    <!--(c) the authors - correct author names and publication date here if necessary. Date in form ', dd.mm.yyyy' after jmir.org-->
    <copyright-statement>©Nils Fischer, Stephen Agboola, Ramya Palacholla, Mursal Atif, Joseph Kvedar, Kamal Jethwani. Originally published in Iproceedings (http://www.iproc.org), 17.09.2018.</copyright-statement>
    <copyright-year>2018</copyright-year>
    <license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/">
      <p>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 Iproceedings, is properly cited. The complete bibliographic information, a link to the original publication on http://www.iproc.org/, as well as this copyright and license information must be included.</p>
    </license>  
    <self-uri xlink:href="http://www.iproc.org/2018/2/e11830/" xlink:type="simple"/>
    <abstract>
      <sec sec-type="background">
        <title>Background</title>
        <p>CORA is a personalized smartphone-based self-management app designed to help cancer patients on oral anti-cancer medications manage medication, medication side-effects, and symptoms with the overall goal of improving their quality of life.</p>
      </sec>
      <sec sec-type="objective">
        <title>Objective</title>
        <p>To evaluate the effect of CORA on quality of life in patients on oral anti-cancer medications.</p>
      </sec>
      <sec sec-type="methods">
        <title>Methods</title>
        <p>Eighty-four patients were randomized to either an intervention group that received CORA plus usual care or a control group that received usual care. Quality of life was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale administered at enrollment, 6 and 12 weeks. Engagement with the app was assessed by determining the unique days using the app. We evaluated the effect of engagement on FACIT-F both as a continuous variable (days using the app) and as a categorical outcome (low, medium, and high). Group differences for all outcomes over the study period were assessed using repeated measures mixed model analysis.</p>
      </sec>
      <sec sec-type="results">
        <title>Results</title>
        <p>Relative to the control group, the intervention group improved FACIT-F by 0.36 (95% CI 0.10-0.61) <italic>P</italic>=.006 per week over the study period. As a continuous variable, each additional day using the app was significantly associated with an improved FACIT-F score per week in the study [0.0060 (95% CI -0.000034-0.012), <italic>P</italic>=.05]. Within the intervention group that used the app, those who were most engaged with the app were significantly more likely to improve their quality of life over the study relative to the least engaged group [0.37 per week (95% CI 0.19-1.94), <italic>P</italic>=.05].</p>
      </sec>
      <sec sec-type="conclusions">
        <title>Conclusions</title>
        <p>CORA may have significantly improved quality of life (FACIT-F) in cancer patients over 12 weeks. Smartphone applications may positively impact health and behavioral outcomes in cancer patients on oral anti-cancer medications.</p>
      </sec>
    </abstract></article-meta>
  </front>
</article>
