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

口服抗癌药物（OAAs）的处方越来越多，现在占新处方的一半以上

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.