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.

口服抗癌药物 (OAA) 的使用越来越多，目前占新处方药物的一半以上 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，并且经常开出OAA。尽管OAA 被认为很方便， 患者及其护理人员对有关这种复杂治疗的信息有强烈的识字需求 并经常遇到许多挑战。他们必须在管理方面表现出自我效能 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-药物或食物-药物相互作用以及家庭环境中的多重用药。 患者和护理人员均报告 OAA 信息不充分，可能影响安全治疗 行政和管理。如今，肿瘤护理正在从肿瘤诊所转向家庭环境， 鉴于减少的医疗服务，这会对如何向患者提供和传达护理产生影响 与肿瘤学提供者面对面接触的频率。老年人报告沟通能力较差 与年轻同行相比，与化疗相关的肿瘤学提供者 老年人容易遭受更糟糕的结果。基于网络的程序提供了一个潜在的解决方案来提高 沟通并产生新的方法来支持癌症护理的自我管理。 这项混合方法研究的具体目标是： 1a) 探索时间、频率和方法的一致性。 患者、护理人员之间有关 OAA 治疗的信息共享和沟通的连续性 和肿瘤医疗保健提供者 1b) 确定患者和护理人员 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 OAA 信息、症状、药物管理自我效能、服用药物的社会支持的满意度 药物、治疗其他合并症的药物、姑息治疗转诊和技术 通过定量调查问卷了解所有权/使用情况； ad 3) 评估基于网络的程序设计功能，这些功能将 协助开发未来的干预工具来管理 OAA 治疗并评估定制的 老年肿瘤患者使用技术时需要考虑的因素。 研究结果将为未来的研究提供信息，其目标是： 1) 开发基于网络的支持性 为接受 OAA 的老年人及其照顾者提供的计划，该计划在理论上是驱动并植根于 老年人的行为改变和技术使用，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。长期目标是通知更大的随机对照试验来测试 基于网络的计划在改善老年患者 OAA 特定结果方面的功效。