Longitudinal trial of smart-phone based social media applications for remote monitoring of cancer patients in the context of a LMIC: compliance, satisfaction, and cost-benefit analysis

The cancer burden is expected to reach 20 million new cases annually in low and middle-income countries (LMICs) by 2025. Few estimates suggest that thyroid cancer could become the third most common cancer diagnosed in women by 2019. Health care services need to gear up to provide close clinical follow-up care for patients especially in LMICs where there is already a shortage of healthcare personnel. We conducted this study to assess the effect of remote monitoring using tele-follow up on compliance, satisfaction and economic benefit. Participants were recruited to traditional hospital follow-up (consultation, clinical examination, and investigations as per hospital policy) or tele-follow up based on social media. Outcomes included information needs, participants’ compliance, and satisfaction, post-op complications, clinical investigations ordered. A total of 64 patients with thyroid cancer were recruited- 24 in hospital follow up group and 40 in the remote monitoring group. There were no significant differences between groups regarding satisfaction with information received. Responses were significantly more positive in the social media group, with a higher percentage reporting “very satisfied”. Wound evaluation through tele-follow up was on par with OPD follow up. If all of these 40 patients would have come to our OPD follow-up, they would have travelled on an average of 930 kms per patient. This study shows that social media is a practical tool in follow-up of cancer patients in LMICs where traditional telemedicine tools are restricted and conventional follow-up is economically challenging to patients. It also ensures compliance which is a major issue with conventional follow-up due to poor infrastructure.