SyMPLER Palliative Care: a qualitative study of patient experiences with a symptom monitoring program and self-referral to specialty palliative care

Purpose Symptom monitoring programs (SMP) and specialty palliative care (PC) improve health-related quality of life through timely symptom management for patients with lung cancer. The primary aim of this study was to assess patients’ perspectives about the feasibility and acceptability of a SMP with a prompted palliative care self-referral option. Methods This is a single-institution qualitative study of patients with lung cancer enrolled in a single-arm feasibility study of a mobile health application (app) that facilitates on-demand reporting of cancer-related symptoms and prompts patients to self-refer to PC for symptom management. Interview participants were purposefully sampled based on high (≥ 3 uses) vs low (0–2 uses) app engagement during the first three months of study enrollment. Questions focused on feasibility and acceptability of the SMP as well as the five main components of the intervention. Individual interviews were conducted from May 2024 – May 2025 by telephone, recorded, transcribed verbatim, and analyzed using thematic analysis. Results Thirty-one patients were interviewed; 21 with high and 10 with low app engagement. Participants were mostly white (93.5%), female (67.7%), and ≥ 60 years of age (61.3%). Most participants were willing and able to report symptoms through the study app and self-refer to PC if needed for symptom management. Participants described technology concerns and low understanding of PC as primary barriers to SMP engagement and PC self-referral, respectively. Conclusion Patients reported that an app-based SMP with integrated PC self-referral was both feasible and acceptable. Incorporation of participant feedback may improve engagement with future iterations of this intervention.