Advanced Symptom Management System for Patients with Malignant Pleural Mesothelioma (ASyMSmeso): Mixed Methods Study
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Abstract
Background: Patients with malignant pleural mesothelioma (MPM) have a life-limiting illness and short prognosis and experience many debilitating symptoms from early in the illness. Innovations such as remote symptom monitoring are needed to enable patients to maintain wellbeing and manage symptoms in a proactive and timely manner. The Advanced Symptom Management System (ASyMS) has been successfully used to monitor symptoms associated with cancer. Objective: This study aimed to determine the feasibility and acceptability of using an ASyMS adapted for use by patients with MPM, called ASyMSmeso, enabling the remote monitoring of symptoms using a smartphone. Methods: This was a convergent mixed methods study using patient-reported outcome measures (PROMs) at key time points over a period of 2-3 months with 18 patients. The Sheffield Profile for Assessment and Referral for Care (SPARC), Technology Acceptance Model (TAM) measure for eHealth, and Lung Cancer Symptom Scale-Mesothelioma (LCSS-Meso) were the PROMs used in the study. Patients were also asked to complete a daily symptom questionnaire on a smartphone throughout the study. At the end of the study, semistructured interviews with 11 health professionals, 8 patients, and 3 carers were conducted to collect their experience with using ASyMSmeso. Results: Eighteen patients with MPM agreed to participate in the study (33.3% response rate). The completion rates of study PROMs were high (97.2%-100%), and completion rates of the daily symptom questionnaire were also high, at 88.5%. There were no significant changes in quality of life, as measured by LCSS-Meso. There were statistically significant improvements in the SPARC psychological need domain (P=.049) and in the “Usefulness” domain of the TAM (P=.022). End-of-study interviews identified that both patients and clinicians found the system quick and easy to use. For patients, in particular, the system provided reassurance about symptom experience and the feeling of being listened to. The clinicians largely viewed the system as feasible and acceptable, and areas that were mentioned included the early management of symptoms and connectivity between patients and clinicians, leading to enhanced communication. Conclusions: This study demonstrates that remote monitoring and management of symptoms of people with MPM using a mobile phone are feasible and acceptable. The evidence supports future trials using remote symptom monitoring to support patients with MPM at home.
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Numerous studies have highlighted the benefits of remote patient monitoring between clinic visits in detecting health deterioration earlier and enabling prompt intervention, particularly for individuals with chronic conditions.
“Numerous studies have highlighted the benefits of remote patient monitoring between clinic visits in detecting health deterioration earlier and enabling prompt intervention, particularly for individuals with chronic conditions [44–50].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [48]
Studies on remote patient monitoring confirm the importance of HCP involvement with digital tools.
“Studies on remote patient monitoring confirm the importance of HCP involvement with digital tools [44–48].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [48]
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“Studies on remote patient monitoring confirm the importance of HCP involvement with digital tools [44–48].”
- Authors
- Maguire, R., Connaghan, J., Arber, A., Klepacz, N., Blyth, K. G., McPhelim, J., Murray, P., Rupani, H., Chauhan, A., Williams, P., McNaughton, L., Woods, K., & Moylan, A.
- Affiliations
- University of Strathclyde (GB)
- University of Surrey (GB)
- NHS Greater Glasgow and Clyde (GB)
- NHS Lanarkshire (GB)
- Ashford and St Peter's Hospitals NHS Foundation Trust (GB)
- Portsmouth Hospitals NHS Trust (GB)
- Corresponding author
- Maguire, Roma
- ORCID
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2020-11-12
- Volume
- 22
- Issue
- 11
- Pages
- e19180
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC7691092
- OpenAlex
- W3102433264
- Cited by
- 38
- References
- 32
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 6 · 2023: 15 · 2021: 2
- FWCI
- 4.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
- Funders
- British Lung Foundation
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- malignant pleural mesothelioma, remote symptom monitoring, feasibility and acceptability, patient-reported outcomes, quality of life, technology acceptance model, SPARC, home care, patient-clinician communication, caregivers
- MeSH terms
- Mesothelioma, Malignant, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Prognosis, Quality of Life, Survival Analysis
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