Many Cancer Management Apps Are Low Quality
Many apps designed to help people manage daily life after a cancer diagnosis, including sticking to their treatment plans and eating a healthy diet, don’t include the tools people actually need to change their behavior, according to a study.
The research was published in the Feb. 1, 2023, issue of the journal JCO Oncology Practice. Read the abstract of “Systematic Evaluation of the Behavior Change Techniques and Quality of Commercially Available Cancer Self-Management Apps.”
About the study
After a cancer diagnosis, you have many more things in your life to manage, including:
completing the full course of all recommended treatments
following recommended guidelines for exercise and healthy eating
coping with side effects
dealing with emotional and psychological issues
Managing all these things well can lead to better outcomes. Still, adding cancer management on top of all your other daily activities can be overwhelming for some people.
A number of companies have developed apps for phones and other devices to help people remember to take their medicine or take a certain number of steps each day. Doctors have started to recommend some of these apps to their patients. But few of these apps are reviewed by the U.S. Food and Drug Administration (FDA), and many of them don’t seem to include the information people need to make better decisions or change their behavior.
To find the best quality apps, researchers reviewed 39 cancer management apps that were available through the Apple iOS App Store and Google Play on April 26, 2022.
Specific breast cancer apps included in the study were:
Becca Breast Cancer Support
Bezzy Breast Cancer
Breast Cancer Questions
My Breast Cancer Coach
Outcomes4Me Breast Cancer Care
OWise Breast Cancer Support
The researchers evaluated the apps in several different ways.
Scientists use a set of 26 behavior change technique taxonomies as a standard way of describing content developed to change behavior, as well as the theories behind that content. The researchers identified all the behavior change techniques in each app.
Research shows that not all behavior change techniques lead to the same changes in behavior. So any results depend on the specific techniques in the app and how the techniques are combined, if there is more than one technique in an app. According to the researchers, when evaluating an app, it’s important to know if the techniques in the app have scientific evidence showing they work.
So the researchers identified a smaller group of 12 behavior change techniques with evidence showing their effectiveness, which they called cancer management behavior change techniques, and noted which apps included these evidenced-based techniques.
The researchers used a standard tool called the Mobile App Rating Scale to measure:
app engagement
functionality
aesthetics
quality of information
subjective quality
Based on these factors, the researchers calculated an overall quality score ranging from one to five for each app. A score of five meant the app’s quality was excellent.
Study results
On average, each app included 5.85 overall behavior change techniques and 3.54 cancer management behavior change techniques. All but one of the apps included at least one cancer management behavior change technique.
The most common cancer management behavior change technique in the apps provided was giving users information about the links between specific behaviors and health. For example, an app might let people know about the link between drinking alcohol and breast cancer risk.
The other two most frequently used cancer management behavior change techniques the apps provided were:
giving users instructions on how to do something
giving users information on the consequences of doing something
Although there is evidence supporting the effectiveness of these cancer management behavior change techniques, the researchers pointed out that the techniques are educational or informational and aren’t likely to change the behavior of all the people who use the app.
The researchers recommended that doctors suggest their patients use apps that have both educational/informational and noneducational/informational techniques.
The researchers gave two examples:
If a person is concerned about managing cancer side effects, apps that include information on side effect management strategies as well as symptom trackers, such as Cancer.Net Mobile, may be appropriate.
If a person needs social support, apps that offer social support features along with education, such as LivingWith: Cancer Support — where people identify members of their support community and ask for help with tasks such as transportation, meals, childcare, and errands — may be appropriate.
The overall quality scores of the apps ranged from 1.69 to 4.20. None of them were excellent-quality apps:
four of the apps were good quality
22 of the apps were acceptable quality
13 of the apps were poor quality
“ . . . Many cancer self-management apps included complicated or overwhelming amounts of information with uncredible or unclear sources,” the researchers wrote. “The three apps with the highest information scores [Cancer.Net Mobile, National Comprehensive Cancer Network Patient Guides for Cancer, and Bezzy Breast Cancer] were developed by professional organizations or in collaboration with healthcare professionals, and similar approaches are recommended to facilitate appropriate and evidence-based content creation.”
What this means for you
If you’re considering using an app to help you manage life during and after breast cancer, the results of this study are disappointing.
Currently, it seems that apps developed by professional organizations, such as the American Society of Clinical Oncology or the National Comprehensive Cancer Network offer the most credible and easy-to-understand information.
It also makes sense to talk to your oncologist or another member of your healthcare team about the app you’re considering and see what they think.
— Last updated on February 22, 2023 at 11:32 PM