Mobile Tool Developed by Conquer Cancer-Supported Researcher Helps Patients in Rural South-East Nigeria Achieve Their Goals of Care

Jan 15, 2021

By Jimmy O’Hara, Conquer Cancer
In South-East Nigeria, a patient with prostate cancer sets a care goal: Organize and attend his only daughter’s wedding. For the Igbo people who live in this region, it is customary for a bride’s father to host his daughter’s traditional wedding; marking this milestone means a lot to this patient and may improve his quality of life. To achieve this goal, the patient must work with his palliative care provider, Tonia Onyeka, MBBS, of the College of Medicine, University of Nigeria Ituku-Ozalla Campus, to manage his symptoms effectively.
In 2017, Dr. Onyeka received a Conquer Cancer International Innovation Grant (IIG) to promote cancer control in low- and middle-income countries (LMICs) by aiding symptom management, encouraging follow-up visits, and enhancing patient access to palliative care. With support from the IIG, Dr. Onyeka developed Enhancing Palliative Care (EPAC), a mobile application for patients living in resource-limited regions to self-report symptoms and remotely connect with their care teams. 
Dr. Onyeka designed the EPAC app to help address the health disparities that patients in rural South-East Nigeria experience. Many of her patients miss appointments due to transportation difficulties, financial barriers, and lack of caregiving support. 
“The IIG inspires home-grown solutions for the peculiar cancer control problems in LMICs,” said Dr. Onyeka. “The app enables patients to report symptoms remotely, at specific times, from the comfort of their homes.”

EPAC: How It Works

The EPAC app lists symptoms and varying degrees of severity. Patients share daily reports with their cancer care teams, who evaluate which patients may need prompt medical attention. Palliative care providers then use the app to connect with patients and offer personalized health advice.
“We found several benefits for its use among patients,” said Dr. Onyeka.
Preliminary data around the EPAC app’s usefulness suggest some areas for improvement, and Dr. Onyeka and her team are ready to shoulder the challenge. She plans to further refine the EPAC app and anticipates releasing it for widespread use by patients in her clinic. She will also explore the tool’s efficacy amidst the COVID-19 pandemic.
For the Igbo father of the bride, who lives more than 100 miles from Dr. Onyeka’s hospital, the EPAC app is his connection to routine clinical care.
“Having the app enabled us to monitor his [progress] and provide prompt medical advice for his symptoms between clinical visits,” said Dr. Onyeka. “Advancing palliative care matters to me because I see it benefit my patients firsthand.”
Dr. Onyeka’s patient was able to host his daughter’s traditional wedding and create once-in-a-lifetime memories with his loved ones. Research made those moments possible.
“This gave us a real sense of achievement, knowing he was able to attain an important milestone in his family life,” said Dr. Onyeka. “Palliative care does make a difference for patients with cancer and their families. That I can provide some relief to patients through palliative care… that is heartwarming to me."
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