@Article{info:doi/10.2196/34851,
author="Vachon, Eric
and Robb, Bruce W
and Haggstrom, David A",
title="Impact of a Personal Health Record Intervention Upon Surveillance Among Colorectal Cancer Survivors: Feasibility Study",
journal="JMIR Cancer",
year="2022",
month="Aug",
day="11",
volume="8",
number="3",
pages="e34851",
keywords="personal health record; colorectal cancer survivors; surveillance; health record; survivor; cancer; oncology; colorectal; United States; North America; feasibility; web-based; patient belief; patient attitude; survival",
abstract="Background: There are currently an estimated 1.5 million individuals living in the United States with colorectal cancer (CRC), and although the 5-year survival rate has increased, survivors are at risk for recurrence, particularly within the first 2-3 years after treatment. National guidelines recommend continued surveillance after resection to identify recurrence early on. Adherence among survivors ranges from 23{\%} to 94{\%}. Novel interventions are needed to increase CRC survivors' knowledge and confidence in managing their cancer and thus to increase adherence to follow-up surveillance. Objective: The objective of this study is to develop and test the feasibility and efficacy of a stand-alone, web-based personal health record (PHR) to increase surveillance adherence among CRC survivors, with patient beliefs about surveillance as secondary outcomes. Methods: A pre- and postintervention feasibility trial was conducted testing the efficacy of the colorectal cancer survivor (CRCS)--PHR, which had been previously developed using an iterative, user-centered design approach. Results: The average age of the sample was 58 (SD 9.9) years, with 57{\%} (16/28) male and the majority married (20/28, 71{\%}) and employed full-time (15/28, 54{\%}). We observed a significant increase in adherence to colonoscopy (before: 11/21, 52{\%} vs after: 18/21, 86{\%}; P=.005) and CEA (14/21, 67{\%} vs 20/21, 95{\%}; P=.01), as well as a slight increase in CT scans (14/21, 67{\%} vs 18/21, 86{\%}; P=.10). The only significant impact on secondary outcome (patient beliefs) was benefits of CEA test (P=.04), as most of the beliefs were high at baseline. Conclusions: This feasibility study lays the groundwork for continued development of the CRCS-PHR to increase CRC surveillance. Patient-centered technologies, such as the CRCS-PHR, represent an important potential approach to improving the receipt of guideline-concordant care and follow-up surveillance, and not just for CRC survivors. Researchers should continue to develop patient-centered health technologies with clinician implementation in mind to increase patient self-efficacy and surveillance adherence. ",
issn="2369-1999",
doi="10.2196/34851",
url="https://cancer.jmir.org/2022/3/e34851",
url="https://doi.org/10.2196/34851",
url="http://www.ncbi.nlm.nih.gov/pubmed/35969424"
}