Background

Cancer-related morbidity and mortality are rising rapidly in low- and middle-income countries (LMICs), where late presentation, limited oncology services, and weak health system infrastructure contribute to high symptom burden and poor quality of life. Palliative care is an essential component of comprehensive cancer control, yet access remains limited, particularly in rural and resource-constrained settings. Digital health technologies offer an opportunity to strengthen continuity of care, symptom monitoring, and clinical decision-making; however, evidence on contextually appropriate, scalable digital palliative care models in LMICs remains scarce.

Objectives

This study aimed to evaluate the feasibility, acceptability, and early outcomes of mPallCare, a digital platform designed to support remote symptom monitoring, clinical communication, and care coordination for people with advanced cancer receiving palliative care in Uganda.

Methods

A mixed-methods pilot evaluation was conducted across selected palliative care services in Uganda. The mPallCare platform was co-designed with local clinicians and integrates patient-reported symptom reporting, clinician dashboards, and referral workflows adapted for low-resource settings. Quantitative data included symptom reporting frequency, clinician response times, and care actions recorded within the platform. Qualitative data were collected through interviews and focus group discussions with patients, caregivers, and healthcare providers to explore usability, perceived value, and implementation challenges. Ethical approvals were obtained locally and internationally.

Results

Preliminary findings demonstrate high acceptability among clinicians and patients, with improved visibility of symptom burden and enhanced communication between care teams and patients. The platform supported earlier identification of uncontrolled pain and distress, prompting timely clinical responses. Healthcare providers reported improved care coordination and greater confidence in monitoring patients remotely, particularly in rural settings. Key implementation challenges included digital literacy variability, intermittent connectivity, and workload pressures, which informed iterative platform refinements and training approaches.

Conclusions / Implications for Practice or Policy

mPallCare demonstrates the potential of digital health tools to strengthen cancer-related palliative care delivery in LMICs by improving symptom monitoring, responsiveness, and continuity of care. Embedding digital palliative care within national cancer control strategies could enhance equity and health system resilience. Further evaluation at scale is warranted to assess long-term clinical outcomes, cost-effectiveness, and policy integration, supporting the translation of digital innovation into sustainable public health action for cancer care.

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