RT Journal Article
T1 Association Between the Use of a Mobile Health Strategy App and Biological Changes in Breast Cancer Survivors: Prospective Pre-Post Study.
A1 Lozano-Lozano, Mario
A1 Melguizo-Rodriguez, Lucia
A1 Fernandez-Lao, Carolina
A1 Galiano-Castillo, Noelia
A1 Cantarero-Villanueva, Irene
A1 Martin-Martin, Lydia
A1 Arroyo-Morales, Manuel
K1 C-reactive protein
K1 breast cancer survivors
K1 interleukin-6
K1 low-grade inflammatory
K1 mHealth
AB There is a bidirectional relationship between chronic low-grade inflammation and cancer. Inflammatory markers, such as interleukin-6 (IL-6), have been associated with both the malignant transformation of epithelial cells and tumor progression, thus linking low-grade inflammation with a higher risk of cancer and recurrence in the survival phase. Therefore, they are considered valuable prognostic biomarkers. Knowing and finding appropriate primary prevention strategies to modify these parameters is a major challenge in reducing the risk of cancer recurrence and increasing survival. Different therapeutic strategies have shown efficacy in the modification of these and other biological parameters, but with contradictory results. There are apparently no strategies in which telemedicine, and specifically mobile health (mHealth), are used as a means to potentially cause biological changes. The objectives of this study were to: (1) check whether it is feasible to find changes in inflammation biomarkers through an mHealth strategy app as a delivery mechanism of an intervention to monitor energy balance; and (2) discover potential predictors of change of these markers in breast cancer survivors (BCSs). A prospective quasi-experimental pre-post study was conducted through an mHealth energy balance monitoring app with 73 BCSs, defined as stage I-IIIA of breast cancer and at least six months from the completion of the adjuvant therapy. Measurements included were biological salivary markers (IL-6 and C-reactive protein [CRP]), self-completed questionnaires (the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, the user version of the Mobile Application Rating Scale [uMARS] and an ad hoc clinical and sociodemographic questionnaire) and physical objective measures (accelerometry, weight and height). In addition, using the logging data of the mHealth app, the rate of use (in days) was recorded during the entire experimental phase of the study. Using Stata software, a paired two-tailed t test, Pearson and Spearman correlations, and a stepwise multiple regression analysis were used to interpret the data. Analyzing changes in inflammatory biomarker concentrations after using the mHealth app, differences between preassessment CRP (4899.04 pg/ml; SD 1085.25) and IL-6 (87.15 pg/ml; SD 33.59) and postassessment CRP (4221.24 pg/ml; SD 911.55) and IL-6 (60.53 pg/ml; SD 36.31) showed a significant decrease in both markers, with a mean difference of -635.25 pg/ml (95% CI -935.65 to -334.85; P In conclusion, through the results of this study, we hypothesize that there is a possible association between an mHealth energy balance monitoring strategy and biological changes in BCSs. These changes could be explained by different biopsychosocial parameters, such as the use of the application itself, quality of life, pain, type of tumor removal surgery, hormonal treatment or obesity.
PB JMIR Publications, Inc.
YR 2019
FD 2019-08-14
LK http://hdl.handle.net/10668/14396
UL http://hdl.handle.net/10668/14396
LA en
NO Lozano-Lozano M, Melguizo-Rodríguez L, Fernández-Lao C, Galiano-Castillo N, Cantarero-Villanueva I, Martín-Martín L, et al. Association Between the Use of a Mobile Health Strategy App and Biological Changes in Breast Cancer Survivors: Prospective Pre-Post Study. J Med Internet Res. 2019 Aug 14;21(8):e15062.
NO The study was funded by the Spanish Ministry of Economy and Competitiveness (Plan Estatal de I+D+I 2013-2016), Fondo de Investigación Sanitaria del Instituto de Salud Carlos III (PI14/01627), Fondos Estructurales de la Unión Europea (FEDER), and by the Spanish Ministry of Education (FPU14/01069 and FPU17/00939). This study took place thanks to additional funding from the University of Granada, Plan Propio de Investigación 2016, Excellence Actions: Units of Excellence; Unit of Excellence on Exercise and Health. This work was part of a PhD thesis conducted in the Clinical Medicine and Public Health Doctoral Studies of the University of Granada, Spain.
DS RISalud
RD Apr 7, 2025