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）越来越多地被处方，现在占新的抗癌药的一半以上。 食品和药物管理局批准的癌症治疗。老年人的发病率最高， 大多数实体瘤癌症并且通常开OAA。尽管推测OAA的便利性， 患者和他们的护理人员对这种复杂治疗的信息有着很高的读写需求 并且经常遇到许多挑战。他们必须表现出自我效能， 复杂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-药物或食物-药物相互作用以及家庭环境中的多种药物。 患者和护理人员都报告说，高龄津贴信息不足，可能影响安全治疗 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， 这对如何向患者提供和传达护理产生了影响，因为 与肿瘤提供者面对面接触的频率。老年人报告说， 与年轻同行相比，与化疗治疗相关的肿瘤学提供者， 老年人容易受到更坏的结果。基于网络的程序提供了一个潜在的解决方案，以增加 沟通和产生新的方法来支持癌症护理的自我管理。 这种混合方法研究的具体目的是：1a）探索时间，频率和 病人、照顾者、 1b）确定患者和护理人员OOA知识差距; 2）评估 与OOA治疗自我管理相关的患者报告结局，包括健康素养， 对高龄津贴信息的满意度、症状、管理药物的自我效能、社会支持 药物、其他合并症的药物、姑息治疗转诊和技术 所有权/使用通过定量问卷;广告3）评估基于网络的程序设计功能， 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 老年肿瘤患者使用技术所需的考虑因素。 调查结果将为未来的研究提供信息，其目标是：1）开发一个支持性的基于网络的 为接受OAA的老年人及其照顾者提供的计划，理论上是受驱动的，并植根于 老年人的行为变化和技术使用; 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RCT进行测试 基于网络的计划改善老年患者OAA特异性结局的有效性。