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.

口服抗癌剂（OAA）越来越被处方，现在占新的一半以上 食品药品监督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，通常是开处方的OAA。尽管OAAS推测便利，但 患者及其护理人员的识字需求陡峭，具体是有关这种复杂治疗的信息 并经常面临许多挑战。他们必须在管理中表现出自我效能 复杂的OAA方案，依从性，症状/副作用管理，监测和报告药物 在家庭环境中的毒性，潜在的药物相互作用以及多药。 患者和看护者都报告说，OAA信息不足，可能会影响安全治疗 管理和管理。今天，肿瘤学护理正在从肿瘤学诊所转移到家庭环境， 鉴于减少 与肿瘤提供者面对面接触的频率。老年人报告沟通较差 与年轻的肿瘤学提供者相比 老年人容易受到更糟的结果。基于Web的程序提供了一种潜在的解决方案来增加 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的是：1a）探索时间，频率和 信息共享和有关OAA治疗的信息的连续性，看护人，看护人， 和肿瘤学医疗保健提供者1B）确定患者和护理人员OOA知识差距； 2）评估 与OOA治疗的自我管理有关的患者报告的结果，包括健康素养， 对OAA信息，症状，管理药物治疗的自我效能，社会支持的满意度 药物，其他合并症的药物，姑息治疗转诊和技术 通过定量问卷的所有权/使用；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来管理OAA治疗并评估自定义 老年人使用技术所需的考虑因素。 调查结果将为未来的研究提供针对未来的研究； 1）开发基于网络的支持 为接受OAA的老年人及其护理人员的计划，理论上驱动并植根于 老年人的行为改变和技术使用以及2）评估基于Web的程序的 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RCT测试 基于Web的计划改善老年人患者的OAA特异性结果的功效。