A randomized controlled trial to assess the effect of mobile health based MedPANDA app on symptomatic self management and medication adherence among patients with leukemia at AIIMS New Delhi

The main focus of the app( intervention) is on the symptom management and medication adherence. Symptoms included in the app are pain, tiredness, nausea, depression, anxiety, drowsiness, loss of appetite, shortness of breath and overall well-being. The app will include features such as written information for symptom management, educational pictures, videos, graphs for symptom tracking and medication reminder.

Management of the following symptoms are included: -

· Pain- Guided management like prescribed medication, deep breathing exercises, encouraging distraction therapies (like music, music therapy and art therapy acc.to patient preferance) and nutrition support.

· Tiredness – light exercises such as walking, stretching and yoga, nutrition support, proper sleep schedule yoga and meditation will be encouraged.

· Nausea- Hydration therapy (ORS), Dietary strategies (ginger tea cinnamon tea, dry crackers before rising, small light frequent meals), behaviour and lifestyle adjustment (sitting upright after eating, deep breathing exercises, meditation and relaxation techniques)

· Depression – Emotional support (open communication with friends and family and community-based cancer supports groups), psychosocial interventions( mindfulness and relaxation, deep breathing exercises, regular social interactions), encouraging hobbies ( art , music and gardening ), physical activity, nutrition and proper sleep will be encouraged.

· Anxiety – Encouraging calm environment, daily routine activities, relaxation techniques, emotional support, yoga, meditation and mindfulness.

· Drowsiness – Encouraging regular sleep schedule, planning daily activities, engaging in hobbies (art, music, gardening, journalling), light exercises (stretching, yoga), balanced diet and hydration.

· Loss of appetite – patient will be advised to focus on small frequent meal and high calorie and protein rich food (Nuts, cheese, yogurt, eggs, chicken), encouraging variety in food (smoothies, shakes, soups), flavourful herbs and spices (like ginger, garlic, cinnamon or mint), oral hygiene (regular brushing and mouthwash and treating mouth sores) encouraging physical activities, meal companionship (family members or friends) and pleasant meal time.

· Overall well-being – Encouraging balanced diet (protein and calorie rich food), regular exercises (walking, yoga, light strength training), hydration, adequate sleep, mindfulness, social well-being, spiritual well-being (prayer, journaling) and self-care.

· Shortness of breath – prescribed medications, breathing exercises (pursed lip breathing, diaphragmatic breathing), positioning (sitting upright) and hydration and electrolyte balance.