Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants

ABSTRACT Introduction Digital symptom monitoring effectively reduces symptom burden in cancer patients receiving treatment. However, concerns persist about whether digital interventions are equitable across racial groups, and limited studies have reported on differences between racial groups. This s...

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Main Authors: Mary Gullatte, Bridget Nicholson, Elizabeth Sloss, Natalya Alekhina, Ann Marie Moraitis, Eli Iacob, Gary Donaldson, Kathi Mooney
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.71026
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author Mary Gullatte
Bridget Nicholson
Elizabeth Sloss
Natalya Alekhina
Ann Marie Moraitis
Eli Iacob
Gary Donaldson
Kathi Mooney
author_facet Mary Gullatte
Bridget Nicholson
Elizabeth Sloss
Natalya Alekhina
Ann Marie Moraitis
Eli Iacob
Gary Donaldson
Kathi Mooney
author_sort Mary Gullatte
collection DOAJ
description ABSTRACT Introduction Digital symptom monitoring effectively reduces symptom burden in cancer patients receiving treatment. However, concerns persist about whether digital interventions are equitable across racial groups, and limited studies have reported on differences between racial groups. This secondary analysis compared engagement, satisfaction, and cancer symptom reduction benefits in Black and White participants utilizing an electronic capture of patient‐reported outcome (ePRO) reporting system, symptom care at home (SCH), throughout chemotherapy. Methods Participants undergoing cancer treatment at a comprehensive cancer center reported daily on the 11 common oncology symptoms via electronic patient reporting (ePRO) on a scale of 0–10. The mean symptom burden over time was compared between Black and White patients. End‐of‐study patient satisfaction ratings were completed and compared between Black and White patients receiving chemotherapy at a comprehensive cancer center in Atlanta, Georgia, USA. Results Of the 357 self‐identified participants, 239 (66.95%) were Black, and 118 (33.05%) were White. Black participants were more likely to be female, have breast cancer, not currently married, and have less than a 4‐year college degree compared to Whites. Black participants had lower adherence to daily symptom reporting (65.25%; SD = 26.90 vs. 72.75%; SD 22.45; p = 0.01), but both groups reported the majority of days. The intervention produced a significant improvement in symptom burden (p < 0.001), with a mean improvement of 0.14 symptom burden points per week with equal benefit between Blacks and Whites (p = 0.27). Overall satisfaction was high for both groups, with a trend toward higher Black satisfaction (p = 0.06). Conclusion Carefully designed digital health technologies can be acceptable and beneficial in reducing symptom burden for both Blacks and Whites. All patients, but particularly Black patients, may benefit from tailored encouragement strategies to report their symptoms. This paper provides evidence that ePRO reporting systems do not perpetuate inequity but, in fact, benefit cancer patients across racial groups.
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spelling doaj-art-60083bd268d44aff80f81afa589785bd2025-08-20T03:15:52ZengWileyCancer Medicine2045-76342025-07-011413n/an/a10.1002/cam4.71026Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White ParticipantsMary Gullatte0Bridget Nicholson1Elizabeth Sloss2Natalya Alekhina3Ann Marie Moraitis4Eli Iacob5Gary Donaldson6Kathi Mooney7Emory University Atlanta Georgia USAUniversity of Utah Salt Lake City Utah USAUniversity of Utah Salt Lake City Utah USAUniversity of Utah Salt Lake City Utah USAUniversity of Rhode Island Providence Rhode Island USAUniversity of Utah Salt Lake City Utah USAUniversity of Utah Salt Lake City Utah USAUniversity of Utah Salt Lake City Utah USAABSTRACT Introduction Digital symptom monitoring effectively reduces symptom burden in cancer patients receiving treatment. However, concerns persist about whether digital interventions are equitable across racial groups, and limited studies have reported on differences between racial groups. This secondary analysis compared engagement, satisfaction, and cancer symptom reduction benefits in Black and White participants utilizing an electronic capture of patient‐reported outcome (ePRO) reporting system, symptom care at home (SCH), throughout chemotherapy. Methods Participants undergoing cancer treatment at a comprehensive cancer center reported daily on the 11 common oncology symptoms via electronic patient reporting (ePRO) on a scale of 0–10. The mean symptom burden over time was compared between Black and White patients. End‐of‐study patient satisfaction ratings were completed and compared between Black and White patients receiving chemotherapy at a comprehensive cancer center in Atlanta, Georgia, USA. Results Of the 357 self‐identified participants, 239 (66.95%) were Black, and 118 (33.05%) were White. Black participants were more likely to be female, have breast cancer, not currently married, and have less than a 4‐year college degree compared to Whites. Black participants had lower adherence to daily symptom reporting (65.25%; SD = 26.90 vs. 72.75%; SD 22.45; p = 0.01), but both groups reported the majority of days. The intervention produced a significant improvement in symptom burden (p < 0.001), with a mean improvement of 0.14 symptom burden points per week with equal benefit between Blacks and Whites (p = 0.27). Overall satisfaction was high for both groups, with a trend toward higher Black satisfaction (p = 0.06). Conclusion Carefully designed digital health technologies can be acceptable and beneficial in reducing symptom burden for both Blacks and Whites. All patients, but particularly Black patients, may benefit from tailored encouragement strategies to report their symptoms. This paper provides evidence that ePRO reporting systems do not perpetuate inequity but, in fact, benefit cancer patients across racial groups.https://doi.org/10.1002/cam4.71026electronic patient reportingePROoncologyremote patient monitoringsymptom science
spellingShingle Mary Gullatte
Bridget Nicholson
Elizabeth Sloss
Natalya Alekhina
Ann Marie Moraitis
Eli Iacob
Gary Donaldson
Kathi Mooney
Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
Cancer Medicine
electronic patient reporting
ePRO
oncology
remote patient monitoring
symptom science
title Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
title_full Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
title_fullStr Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
title_full_unstemmed Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
title_short Digital Patient–Reported Cancer Symptom Management: Comparison of Black and White Participants
title_sort digital patient reported cancer symptom management comparison of black and white participants
topic electronic patient reporting
ePRO
oncology
remote patient monitoring
symptom science
url https://doi.org/10.1002/cam4.71026
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