Exploring the Use of a Web-Based Program for Older Adults Receiving Oral Anticancer Agents to Improve Communication and Self-Management

探索使用基于网络的程序为接受口服抗癌药物的老年人改善沟通和自我管理

• 批准号: 10579689
• 负责人: Victoria Kate Marshall
• 金额: $ 7.48万
• 依托单位: UNIVERSITY OF SOUTH FLORIDA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-01-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10579689
• 关键词: Address; Adherence; Adult; Affect; Android; Antineoplastic Agents; Behavioral; Caregivers; Caring; Cellular Phone; Clinic; Communication; Complex; Computers; Continuity of Patient Care; Data; Development; Dose; Drug toxicity; Elderly; Food-Drug Interactions; Frequencies; Funding; Future; Glean; Goals; Grant; Health Insurance; Health Personnel; Health Technology; Home; Home environment; Incidence; Income; Instruction; Internet; Intervention; Intervention Studies; Interview; Knowledge; Malignant Neoplasms; Managed Care; Medication Management; Methods; Mobile Health Application; Modeling; Monitor; Motivation; Oncology; Online Systems; Oral; Outcome; Ownership; Palliative Care; Patient Outcomes Assessments; Patients; Perception; Personal Computers; Pharmaceutical Preparations; Pharmacologic Substance; Polypharmacy; Problem Solving; Program Acceptability; Provider; Questionnaires; Randomized, Controlled Trials; Regimen; Reporting; Research; Self Efficacy; Self Management; Social support; Solid Neoplasm; Symptoms; Tablets; Technology; Theory of Change; Time; United States Food and Drug Administration; behavior change; cancer care; cancer therapy; care providers; chemotherapy; comorbidity; coping; design; efficacy testing; financial toxicity; flexibility; health literacy; human old age (65+); improved; insight; literacy; mHealth; medication administration; programs; response; satisfaction; side effect; symptom management; technology platform; tool; treatment comparison; usability; web-based assessment

Oral anticancer agents (OAAs) are increasingly being prescribed and now account for over half of the new cancer treatments approved by the Food and Drug Administration. Older adults have the highest incidence of most solid tumor cancers and are often prescribed OAAs. Despite the speculated convenience of OAAs, patients and their caregivers have steep literacy needs specific to information regarding this complex treatment and are often met with numerous challenges. They must demonstrate self-efficacy in the management of complex OAA regimens, adherence, symptom/side effect management, monitoring and reporting of drug toxicities, potential drug-drug or food-drug interactions, and polypharmacy in the home environment. Both patients and caregivers report that OAA information is inadequate, potentially affecting safe treatment administration and management. Today, oncology care is shifting from oncology clinics to home environments, resulting in implications for how care is delivered and communicated to patients, given the decreased frequency of face-to face contact with oncology providers. Older adults have reported worse communication with oncology providers related to chemotherapy treatment compared with their younger counterparts, leaving older adults vulnerable to worse outcomes. Web-based programs offer a potential solution to increase communication and generate new ways to support self-management of cancer care. The specific aims of this mixed methods study are to: 1a) Explore concordance of the timing, frequency, and continuity of information sharing and communication regarding OAA treatment between patients, caregivers, and oncology health care providers 1b) Identify patient and caregiver OOA knowledge gaps; 2) Evaluate patient-reported outcomes associated with the self-management of OOA treatment including health literacy, satisfaction with OAA information, symptoms, self-efficacy for managing medication, social support for taking medications, medications taken for other comorbid conditions, palliative care referral,and technology ownership/use via quantitative questionnaires; ad 3) Assess web-based program design features that will assist in the development of a future intervention tool to manage OAA treatment and to evaluate customized considerations needed for older adult oncology patients using technology. Findings will inform future research with aims geared towards; 1) development of a supportive web-based program for older adults receiving OAAs and their caregivers that is theoretically driven and rooted in behavioral change and technology use in older adults and 2) evaluating the web-based program for acceptability, usability, feasibility, and user engagement. The long-term goal is to inform a larger RCT to test the efficacy of the web-based program to improve OAA-specific outcomes of older adult patients.

口服抗癌药(OAA)的处方越来越多，现在占新处方的一半以上 美国食品和药物管理局批准的癌症治疗方法。老年人的发病率最高。 大多数实体瘤癌症，经常被开OAA处方。尽管OAA被认为是方便的， 患者和他们的照顾者对关于这种复杂治疗的信息有强烈的识字需求 并且经常会遇到无数的挑战。他们必须在管理工作中表现出自我效能感 复杂的OAA方案、依从性、症状/副作用管理、药物监测和报告 毒性，潜在的药物-药物或食品-药物相互作用，以及家庭环境中的多药联用。 患者和照顾者都报告说，OAA信息不充分，可能会影响安全治疗 行政和管理。今天，肿瘤治疗正在从肿瘤诊所转移到家庭环境中， 导致对如何向患者提供和沟通护理的影响，因为 与肿瘤科提供者面对面接触的频率。据报道，老年人的沟通能力较差 与与化疗相关的肿瘤科提供者相比，他们离开了年轻的同行 老年人容易受到更糟糕的结果的影响。基于Web的程序提供了一个潜在的解决方案来提高 交流和产生新的方法，以支持癌症护理的自我管理。 这项混合方法研究的具体目的是：1)探索时间、频率和 持续不断地在患者、照顾者、 和肿瘤学保健提供者1b)确定患者和护理人员的OOA知识差距；2)评估 患者报告的与OOA治疗自我管理相关的结果，包括健康素养， 对高龄津贴信息、症状、用药自我效能、服药社会支持的满意度 药物、针对其他合并症的药物、姑息治疗转诊和技术 通过量化问卷拥有/使用；广告3)评估基于网络的计划设计功能，这些功能将 协助开发未来的干预工具，以管理高龄津贴治疗并评估定制的 使用技术的老年肿瘤患者需要考虑的问题。 这些发现将为未来的研究提供信息，其目标是：1)开发支持性的基于网络的 为接受OAA及其照顾者的老年人提供的计划，从理论上讲是由 老年人的行为变化和技术使用以及2)评估基于网络的计划 可接受性、可用性、可行性和用户参与度。长期目标是通知一个更大的随机对照试验进行测试 基于网络的计划对改善老年OAA患者特定结局的有效性。