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Patient-Centered Innovations, Education and Technology for Cancer Care, Cancer Survivorship and Cancer Research
JMIR Cancer (JC) is a Pubmed-indexed, peer-reviewed journal with a focus on education, innovation and technology in cancer care, cancer survivorship and cancer research, as well as in participatory and patient-centred approaches. A sister journal of the Journal of Medical Internet Research (JMIR), a leading eHealth journal (Impact Factor 2016: 5.175), the scope of JC is broader and includes non-Internet approaches to improve cancer care and cancer research.
We invite submission of original research, viewpoints, reviews, tutorials, case studies, and non-conventional articles (e.g. open patient education material and software resources that are not yet evaluated but free for others to use/implement).
In our "Patients' Corner", we invite patients and survivors to submit short essays and viewpoints on all aspects of cancer, but in particular suggestions on how to improve the health care system, and suggestions for new technologies, applications and approaches (no article processing fees).
JC is open access and all articles are published under a Creative Commons Attribution license. JC has been accepted for indexing in PubMed Central and Pubmed.
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Background: Clinical trials are essential to the advancement of cancer treatment but fewer than 5% of adult cancer patients enroll in a trial. A commonly cited barrier to participation is the lack of...
Background: Clinical trials are essential to the advancement of cancer treatment but fewer than 5% of adult cancer patients enroll in a trial. A commonly cited barrier to participation is the lack of understanding about clinical trials. Objective: Since the Internet is a popular source of health-related information and YouTube™ is the second most visited website in the world, we examined the content of the top 115 YouTube™ videos about clinical trials to evaluate clinical trial information available through this medium. Methods: YouTube™ videos posted prior to March 2017 were searched using selected keywords. A snowballing technique was used to identify videos for review in which sequential screening of the autofill search results for each set of keywords was conducted. Video characteristics (e.g., number of views, length) were recorded. Content was broadly grouped as related to purpose, phases, design, safety and ethics, and participant considerations. Multivariable regression analysis was conducted to assess associations between video type (cancer vs. non-cancer) and video characteristics and content. Results: In total, 115 videos were reviewed; 46 (40.0%) cancer clinical trials videos vs. 69 (60.0%) non-cancer videos. Most videos were created by healthcare organizations/cancer centers (29.6%), were oriented toward patients (58.3%) and the general public (59.1%) and were informational (68.7%); altruism was a common theme (27.0%). Compared to non-cancer videos, cancer clinical trials videos more frequently used an affective approach and mentioned benefits of participation. Cancer clinical trial videos also were much more likely raise the issue of costs associated with participation (OR 5.93, 95% CI 1.15-29.46), and to advise patients to communicate with their physician about cancer clinical trials (OR 4.94, 95% CI 1.39-17.56). Conclusions: Collectively, YouTube™ clinical trial videos provided information on many aspects of trials but, individual videos tended to focus on selected topics with varying level of detail. Cancer clinical trial videos, more emotional in tone, provided information on the important topics of cost and communication. Patients are encouraged to verify and supplement YouTube™ video information with consultations with their healthcare professional to obtain a full and accurate picture of cancer clinical trials in order to make adequately informed decision about participation.
Background: A fundamental limitation in the field of medication adherence is measurement of real-time medication-taking behavior that can be used to identify specific barriers and individualize interv...
Background: A fundamental limitation in the field of medication adherence is measurement of real-time medication-taking behavior that can be used to identify specific barriers and individualize intervention. Advanced Sensored Medication Devices (SMDs) can capture and transmit real-time information when a scheduled device opening is missed. Many recently approved medications in multiple myeloma (MM) are oral and taken on complex and irregular schedules. These new oral agents have resulted in improved survival, but adherence is a concern. Objective: To: 1) identify patient-reported barriers to medication adherence; and 2) understand patients’ attitudes towards the use of SMDs in a group of patients from lower socioeconomic backgrounds in treatment for MM. Methods: An in-person, semi-structured, qualitative interview was conducted with a convenience sample of patients being treated for MM. Patients were recruited from within an urban, minority-serving, academic medical center that had an established cancer center. Using a standardized interview guide, patients were asked about comfort with technology, experience with taking daily medications before being diagnosed with MM, and experiences with missing doses of oral anticancer medications and contributing factors. This transitioned into showing patients two different pill bottles with sensor-technology – Medication Event Monitoring System® and the SMRxT® bottle. After receiving information on the transmission ability of the bottles, patients were asked to discuss their reactions and concerns with the idea of using such a device. The interviews were audio-recorded and transcribed. Interviews were independently coded by two members of the team with a third providing guidance. Results: Twenty patients participated having a mean age of 56 years (range=29-71 years) and 70% were African American. Over half of the patients described themselves as having some degree of comfort with technology referring to the internet, text messaging, and cellphone applications. Twelve patients (60%) reported that their first experience taking daily medications was related to the MM treatments. The average number of medications reported per patient was 13 medications (range = 3 to 24). Fourteen (70%) reported missed doses for a range of reasons such as fatigue, feeling ill, a busy schedule, forgetting, or side effects. Interest in using a SMD ranged from great interest to complete lack of interest. Examples of concerns related to the SMDs included privacy issues, potential added cost, and the size of the bottle (i.e. too large). Despite the concerns twelve (60%) patients expressed interest in trying a bottle in the future. Conclusions: Despite the small sample, patients reported numerous factors that contributed to missed doses of oral anti-cancer therapy. Many of these appear to be potentially mutable if uncovered and addressed. SMDs may allow for real-time capture of this data. While patients expressed concerns with SMDs, most remained willing to use one. A feasibility trial with SMDs is planned.