Evaluation of a prostate cancer aftercare app from the patient perspective: A qualitative study

Introduction: The project "Digital unterstutzte Prostatakrebsnachsorge in Schleswig-Holstein" (Digitally supported prostate cancer aftercare in Schleswig-Holstein) funded by the federal state of Schleswig-Holstein aims to test the app "Nachsorge-Pass" (Patient Aftercare Book) in the care of prostate cancer patients after seed brachytherapy. In order to evaluate the app from the patient perspective a qualitative study was conducted which examined usability, usefulness and potential for improvement. Methods: All patients using the app at the start of the study were invited to participate in semi-structured telephone interviews; 12 of 20 users (60%) followed the invitation. In addition, the questionnaire "System Usability Scale" (SUS) was applied. Qualitative content analysis was used to interpret the interviews. Results: The evaluation revealed that, overall, the app was regarded as very user-friendly, though some users encountered difficulties during the installation of the app and technical problems afterwards. Some patients experienced a feeling of security resulting from the symptom monitoring. Other participants did not see a personal benefit, but made suggestions for improvement in order to make the app more useful. Discussion: Symptom monitoring through the app "Nachsorge-Pass" has shown to be feasible. Potential for improvement includes the representation of the symptom course for patients, a stronger focus on psychosocial aspects, and a better integration of the app into the ongoing aftercare process. As soon as the number of users is high enough, a randomised controlled trial should be conducted in order to collect reliable evidence on the effectiveness of the app. Conclusion: The present study provides first clues about a patient-oriented design of an app for prostate cancer aftercare, which has shown a high level of user-friendliness in the first test with patients. Further development should take place in iterative cycles involving both users and health care professionals.