CoChat
Sign Up
Cited by 10Palliative Care and End-of-Life IssuesMobile Health and mHealth ApplicationsPalliative and Oncologic Care

How a Digital Case Management Platform Affects Community-Based Palliative Care of Sub-Saharan African Cancer Patients: Clinician-Users' Perspectives

Open access
Ho, Yun Xian, Morse, Robert S., Lambden, Kaley, Mushi, Beatrice P., Ngoma, Mamsau, Mahuna, Habiba, Ngoma, Twalib, Miesfeldt, Susan·2022·Applied Clinical Informatics
DOI 10.1055/s-0042-1758223PMC PMC9668489
Open this paper in CoChat — free accountOpen PDF

Abstract

Background Symptom control among cancer patients is a Tanzanian public health priority impacted by limited access to palliative care (PC) specialists and resources. Mobile Palliative Care Link (mPCL), a mobile/web application, aims to extend specialist access via shared care with local health workers (LHWs) with the African Palliative care Outcome Scale (POS) adapted for regular, automated symptom assessment as a core feature. Objective The aim of the study is to assess clinicians' attitudes, beliefs, and perceptions regarding mPCL usability and utility with their patients within a government-supported, urban Tanzanian cancer hospital setting. Methods We used a mixed methods approach including surveys, qualitative interviews, and system usage data to assess clinicians' experience with mPCL in a field study where discharged, untreatable cancer patients were randomized to mPCL or phone-contact POS collection. Results All six specialists and 10 LHWs expressed overall satisfaction with mPCL among 49 intervention arm patients. They perceived mPCL as a way to stay connected with patients and support remote symptom control. Timely access to POS responses and medical records were identified as key benefits. Some differences in perceptions of mPCL use and utility were seen between clinician groups; however, both expressed strong interest in continuing app use, recommending it to colleagues, and extending use throughout Tanzania. Primary use was for clinical status communication and care coordination. Pain and other symptom progression were the most frequently reported reasons for provider–patient interactions accounting for 34% (n = 44) and 12% (n = 15) of reasons, respectively. Usage barriers included time required to create a new clinical record, perceived need for response to non-urgent reminders or alerts, and training. necessary for competent use. System-level implementation barriers included variable patient access to smartphones and SIM cards and unreliable Internet access. Conclusion This work demonstrates broad clinician desire for digital health tools to support remote community-based PC among cancer patients, particularly pain management.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1055/s-0042-1758223

Cites

3 of 3 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • A human-centered mobile and web application (mPCL) in Tanzania extended functionality beyond patient-facing use to support coordinated palliative care among patients, caregivers, and local health workers.

    “a human-centered mobile and web application (mPCL) [23] in Tanzania, which extended functionality beyond patient-facing use to support coordinated palliative care among patients, caregivers, and local health workers.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [23]

  • The mPCL project by Ho et al [23] incorporated local health workers in Tanzania to co-design a mobile platform for palliative care, ensuring cultural and contextual relevance in a low-resource setting.

    “Similarly, the mPCL project by Ho et al [23] incorporated local health workers in Tanzania to co-design a mobile platform for palliative care, ensuring cultural and contextual relevance in a low-resource setting.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [23]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 23

  1. [1]Bray F Ferlay J Soerjomataram I Siegel R L Torre L A Jemal A Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries CA Cancer J Clin 2018 68 06 394 424 30207593
  2. [2]Jemal A Bray F Forman D Cancer burden in Africa and opportunities for prevention Cancer 2012 118 18 4372 4384 22252462
  3. [3]Parkin D M Bray F Ferlay J Jemal A Cancer in Africa 2012 Cancer Epidemiol Biomarkers Prev 2014 23 06 953 966 24700176
  4. [4]Siegel R L Miller K D Jemal A Cancer statistics, 2020 CA Cancer J Clin 2020 70 01 7 30 31912902
  5. [5]Rebbeck T R Cancer in sub-Saharan Africa Science 2020 367(6473): 27 28 31896706
  6. [6]Chen Z Xu L Shi W Trends of female and male breast cancer incidence at the global, regional, and national levels, 1990-2017 Breast Cancer Res Treat 2020 180 02 481 490 32056055
  7. [7]Mathers C D Loncar D Projections of global mortality and burden of disease from 2002 to 2030 PLoS Med 2006 3 11 e442 17132052 PMC1664601
  8. [8]Harding R Selman L Agupio G Validation of a core outcome measure for palliative care in Africa: the APCA African Palliative Outcome Scale Health Qual Life Outcomes 2010 8 01 10 20100332 PMC2825183
  9. [9]El-Jawahri A Greer J A Temel J S Does palliative care improve outcomes for patients with incurable illness? A review of the evidence J Support Oncol 2011 9 03 87 94 21702398
  10. [10]Temel J S Greer J A Muzikansky A Early palliative care for patients with metastatic non-small-cell lung cancer N Engl J Med 2010 363 08 733 742 20818875
  11. [11]Harding R Selman L Powell R A Research into palliative care in sub-Saharan Africa Lancet Oncol 2013 14 04 e183 e188 23561750
  12. [12]Bates M J Namisango E Tomeny E Muula A Squire S B Niessen L Palliative care within universal health coverage: the Malawi Patient-and-Carer Cancer Cost SurveyBMJ Support Palliat Care 2019:bmjspcare-2019-001945 31582382
  13. [13]Ochieng W Advanced cancer palliative care economics in sub-Saharan Africa: an important start Lancet Glob Health 2021 9 12 e1638 e1639 34756182 PMC12099912
  14. [15]Holst C Sukums F Radovanovic D Ngowi B Noll J Winkler A S Sub-Saharan Africa-the new breeding ground for global digital health Lancet Digit Health 2020 2 04 e160 e162 33328076
  15. [18]Holden R J Karsh B T The technology acceptance model: its past and its future in health care J Biomed Inform 2010 43 01 159 172 19615467 PMC2814963
  16. [20]Nguyen M Fujioka J Wentlandt K Using the technology acceptance model to explore health provider and administrator perceptions of the usefulness and ease of using technology in palliative care BMC Palliat Care 2020 19 01 138 32895060 PMC7476427
  17. [22]Zakerabasali S Ayyoubzadeh S M Baniasadi T Yazdani A Abhari S Mobile health technology and healthcare providers: systemic barriers to adoption Healthc Inform Res 2021 27 04 267 278 34788907 PMC8654335
  18. [24]Ngoma M Mushi B Morse R S mPalliative care link: examination of a mobile solution to palliative care coordination among Tanzanian patients with cancer JCO Glob Oncol 2021 7 07 1306 1315 34406856 PMC8457843
  19. [27]Hsieh H F Shannon S E Three approaches to qualitative content analysis Qual Health Res 2005 15 09 1277 1288 16204405
  20. [28]Jette D U Halbert J Iverson C Miceli E Shah P Use of standardized outcome measures in physical therapist practice: perceptions and applications Phys Ther 2009 89 02 125 135 19074618
  21. [30]Cohen D J Crabtree B F Evaluative criteria for qualitative research in health care: controversies and recommendations Ann Fam Med 2008 6 04 331 339 18626033 PMC2478498
  22. [31]Prater L Sanchez A Modan G Electronic health record documentation patterns of recorded primary care visits focused on complex communication: a qualitative study Appl Clin Inform 2019 10 02 247 253 30970382 PMC6458018
  23. [33]Reichheld F F The one number you need to grow Harv Bus Rev 2003 81 12 46 54, 124 14712543

Cited by

Sorted by citations

Authors
Ho, Y. X., Morse, R. S., Lambden, K., Mushi, B. P., Ngoma, M., Mahuna, H., Ngoma, T., & Miesfeldt, S.
Affiliations
  • Dimagi (United States) (US)
  • DaVinci Usability, Inc., Lexington, Massachusetts, United States
  • Muhimbili University of Health and Allied Sciences (TZ)
  • Ocean Road Cancer Institute (TZ)
  • Maine Medical Center (US)
ORCID
Venue
Applied Clinical Informatics
Publisher
Georg Thieme Verlag KG
Published
2022-10
Volume
13
Issue
05
Pages
1092-1099
ISSN
1869-0327 (ISSN-L)
DOI
10.1055/s-0042-1758223
PMC
PMC9668489
OpenAlex
W4309146628
Cited by
10
References
3
Citations by year
2026: 3 · 2025: 2 · 2024: 4 · 2023: 1
FWCI
1.55
Type
journal article
Language
en
Open access
Licence
Locations
  • Applied Clinical Informatics (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Funders
Fogarty International Center (R21TW010190)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
community-based palliative care, cancer patients, mobile health apps, symptom assessment, clinician perceptions, usability, pain management, implementation barriers, Tanzania
MeSH terms
Humans, Neoplasms, Palliative Care, Specialization, Africa South of the Sahara, Case Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review