Ecological Momentary Assessment in Palliative Care: A Qualitative Study of Patient and Clinician Perspectives

Abstract

Introduction

Symptom management tools based on ecological momentary assessment (EMA) may improve symptom tracking and enhance patient-provider communication in ambulatory palliative care (PC), but their design and implementation must align with the needs of patients and clinicians. This study aimed to explore patient and clinician perspectives on the potential role, design considerations, and implementation challenges of implementing EMA-based tools in ambulatory PC settings.

Method

We conducted an exploratory-descriptive qualitative study using semi-structured interviews with 10 patients and 9 clinicians recruited from the ambulatory palliative care clinic of an academic medical center. Interviews were transcribed and analyzed using a hybrid inductive-deductive thematic analysis approach. Coding was conducted by a multidisciplinary team, and themes were developed through iterative team discussions.

Results

Four themes emerged: (1) EMA-based tools can enhance symptom tracking and communication; (2) equity and access must be prioritized to avoid digital exclusion; (3) balancing simplicity and personalization is essential to minimize burden and optimize engagement; and (4) integration into clinical workflows is critical for uptake. Participants emphasized the need for tools that are easy to use, customizable, and embedded in existing systems, with clear protocols for triage and support.

Conclusion

EMA-based tools have the potential to improve symptom management and communication in ambulatory PC, but must be designed with attention to usability, equity, and workflow integration. Our study findings can inform the co-design of EMA-based tools that are responsive to the needs of patients receiving (and clinicians providing) serious illness care.