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

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.

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.

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).

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.