title: Ambulant monitoring and web-accessible home-based exercise program during outpatient follow-up for resected lung cancer survivors: actual use and feasibility in clinical practice.
abstract: OBJECTIVE
  The aim of this study is to evaluate the feasibility of a telehealthcare application for operable lung cancer (OLC) patients, consisting of ambulant symptom and physical activity monitoring (S&PAM) and a web-accessible home-based exercise program (WEP), and identify possible barriers for successful adoption and implementation.
  
  
  METHODS
  A two-stage mixed methods design was used, in which 22 OLC patients and their treating healthcare professionals (HCPs) participated from pre-surgery to three (stage 1; n = 10) or six (stage 2; n = 12) months post-surgery. Actual use and acceptability (usability, usefulness, and satisfaction) were evaluated.
  
  
  RESULTS
  Seventeen OLC patients (age (SD): 59 (8) years; 8 female) actively used the modules. S&PAM use varied from 1 to 11 monitoring days prior to outpatient consultations. Patients used WEP most frequently during the first 5 weeks, with an average of four logins a week. Fifty-eight percent used WEP beyond 7 weeks. No adverse situations occurred, and patients felt confident using the applications. Perceived added value included active lifestyle promotion, decreased anxiety, and accessibility to specialized HCPs. Physiotherapists used WEP as intended. Contrarily, physicians scarcely used information from S&PAM. To promote future adoption, strategies should focus on high-level patient tailoring of the technology, and formalization of including the applications in the clinical workflow.
  
  
  CONCLUSIONS
  Ambulant monitoring and web-accessible home exercise is clinically feasible for OLC patients. However, low level of adoption by referring physicians may hamper successful implementation.
  
  
  CONCLUSIONS
  Patients perceived both ambulant monitoring and web-accessible exercise as an added value to regular care and feasible to use in the period before and after lung resection.
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands. j.g.timmerman@utwente.nl.|Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine Group, University of Twente, Enschede, The Netherlands. j.g.timmerman@utwente.nl.
authors.forename: J G
authors.initials: JG
authors.lastname: Timmerman
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands.
authors.forename: M G H
authors.initials: MGH
authors.lastname: Dekker-van Weering
authors.affiliation: The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: M M
authors.initials: MM
authors.lastname: Stuiver
authors.affiliation: The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: W G
authors.initials: WG
authors.lastname: Groen
authors.affiliation: The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: M W J M
authors.initials: MWJM
authors.lastname: Wouters
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands.
authors.forename: T M
authors.initials: TM
authors.lastname: Tönis
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands.|Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine Group, University of Twente, Enschede, The Netherlands.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hermens
authors.affiliation: Faculty of Electrical Engineering, Mathematics and Computer Science, Telemedicine Group, University of Twente, Enschede, The Netherlands.|Ziekenhuis Groep Twente, Almelo, The Netherlands.
authors.forename: M M R
authors.initials: MMR
authors.lastname: Vollenbroek-Hutten
mesh_terms: D000073116:Cancer Survivors / Q000523:psychology*; D005081:Exercise Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000601:surgery*; D008875:Middle Aged; D010045:Outpatients; D017216:Telemedicine / Q000379:methods*
keywords: Cancer survivorship; Feasibility; Implementation; Lung cancer; Rehabilitation; Telehealthcare