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Older cancer survivors' perspectives and use of telehealth in their cancer survivorship care in the United States: A ResearchMatch® sample

  • Elizabeth K. Arthur
    Affiliations
    Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH 43210, USA

    College of Nursing, The Ohio State University, 1585 Neil Ave., Columbus, OH 43210, USA
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  • Janell Pisegna
    Affiliations
    Physical Therapy Program, University of Colorado Anschutz Medical Campus, 13001 E 17th Ave., Aurora, CO 80045, USA
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  • Jill M. Oliveri
    Affiliations
    Recruitment, Intervention and Survey Shared Resource, Comprehensive Cancer Center, The Ohio State University, 1590 N. High St, Suite 525, Columbus, OH 43201, USA
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  • Heather Aker
    Affiliations
    Recruitment, Intervention and Survey Shared Resource, Comprehensive Cancer Center, The Ohio State University, 1590 N. High St, Suite 525, Columbus, OH 43201, USA
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  • Jessica L. Krok-Schoen
    Correspondence
    Corresponding author at: The Ohio State University, 228 Atwell Hall 453 W. 10th Ave, Columbus, OH 43210, USA.
    Affiliations
    Comprehensive Cancer Center, The Ohio State University, 460 W. 10th Ave, Columbus, OH 43210, USA

    Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10th Ave, 228 Atwell Hall, Columbus, OH 43210, USA
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Published:August 16, 2022DOI:https://doi.org/10.1016/j.jgo.2022.08.004

      Abstract

      Introduction

      COVID-19 has resulted in reliance on telecommunication technologies for the provision of supportive cancer care. However, research on the use of these resources among older adults, who are the majority of cancer survivors, is limited. The objective of this study was to gather information on older cancer survivors' perspectives and use of telehealth their cancer survivorship care in the United States.

      Materials and Methods

      Potential participants were recruited through ResearchMatch® from December 2020–January 2021. Online semi-structured interviews were conducted. Descriptive statistics were used to analyze the participants' demographic and health characteristics. Content analysis were conducted by two independent coders for identification of common themes. Coding agreement was reached through consensus, and count comparisons of participant responses were made.

      Results

      The majority of respondents (n = 21; mean age = 73.5 ± 4.9) were female (57%), White (90%), and had a variety of cancer diagnoses. Participants reported using a variety of technology devices and telehealth products. Older cancer survivors (n = 10) endorsed telehealth video use for physical health concerns and basic check-ups, but some (n = 4) preferred in-person visits for major concerns and sensitive issues (e.g., mental health). Half of participants reported mobile health app use; however, ten participants did not use these apps as they felt the technology was not useful. Barriers to health technology use included missing face-to-face connections with providers, lack of familiarity with the technology, and perceived lack of utility and personalized telehealth platforms. Lastly, video-based conferencing and social media site use among seventeen participants was reported for social interaction during the COVID-19 pandemic.

      Discussion

      These findings suggest that older cancer survivors utilize online platforms for their general health; however, they prefer in-person visits for serious issues and value personalization with telehealth. Despite from a highly educated sample of ResearchMatch® participants, these results can be used to inform clinicians and researchers about the appropriateness and provision of telehealth-based supportive care among older cancer survivors.

      Keywords

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      References

        • Siegel R.L.
        • Miller K.D.
        • Fuchs H.E.
        • Jemal A.
        • Jemal A.
        Cancer statistics, 2022.
        Cancer. 2022; 72: 7-33
        • Smith B.D.
        • Smith G.L.
        • Hurria A.
        • Hortobagyi G.N.
        • Buchholz T.A.
        Future of cancer incidence in the United States: burdens upon an aging, changing nation.
        J Clin Oncol. 2009; 27: 2758-2765
        • Hill-Kayser C.E.
        • Vachani C.
        • Hampshire M.K.
        • Di Lullo G.A.
        • Metz J.M.
        The role of internet-based cancer survivorship care plans in care of the elderly.
        J Geriatr Oncol. 2011; 2: 58-63
        • Faul L.A.
        • Luta G.
        • Sheppard V.
        • Isaacs C.
        • Cohen H.J.
        • Muss H.B.
        • et al.
        Associations among survivorship care plans, experiences of survivorship care, and functioning in older breast cancer survivors.
        J Cancer Surviv. 2014; 8: 627-637
        • Mohile S.G.
        • Hurria A.
        • Cohen H.J.
        • Rowland J.H.
        • Leach C.R.
        • Arora N.K.
        • et al.
        Improving the quality of survivorship for older adults with cancer.
        Cancer. 2016; 122: 2459-2568
        • Jacobsen P.B.
        • Derosa A.P.
        • Henderson T.O.
        • Mayer D.K.
        • Moskowitz C.S.
        • Paskett E.D.
        • et al.
        Systematic review of the impact of cancer survivorship care plans on health outcomes and health care delivery.
        J Clin Oncol. 2018; 36: 2088-2100
        • Lopez A.M.
        • Lam K.
        • Thota R.
        Barriers and facilitators to telemedicine: can you hear me now?.
        Am Soc Clin Oncol Educ Book. 2021; 41: 25-36
        • Sirintrapun S.J.
        • Lopez A.M.
        Telemedicine in cancer care.
        Am Soc Clin Oncol Educ Book. 2018; 2018: 540-545
        • Abbott D.E.
        • Voils C.L.
        • Fisher D.A.
        • Greenberg C.C.
        • Safdar N.
        Socioeconomic disparities, financial toxicity, and opportunities for enhanced system efficiencies for patients with cancer.
        J Surg Oncol. 2017; 115: 250-256
        • United States Congress
        Bipartisan Budget Act of 2018.
        ([accessed 18 May 2022])
        • Paterson C.
        • Bacon R.
        • Dwyer R.
        • Morrison K.S.
        • Toohey K.
        • O’Dea A.
        • et al.
        The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: implications for practice.
        Semin Oncol Nurs. 2020; 36151090
        • Perrin A.
        Mobile technology and home broadband.
        Pew Research Center Report, 2021 ([accessed 18 May 2022])
        • Choi N.G.
        • Dinitto D.M.
        • Marti C.N.
        • Choi B.Y.
        Telehealth use among older adults during COVID-19: associations with sociodemographic and health characteristics, technology device ownership, and technology learning.
        J Appl Gerontol. 2021; 0: 1-10
        • Kruse C.
        • Fohn J.
        • Wilson N.
        • Nunez Patlan E.
        • Zipp S.
        • et al.
        Utilization barriers and medical outcomes commensurate with the use of telehealth among older adults: systematic review.
        JMIR Med Inform. 2020; 8e20359
        • Bizot A.
        • Karimi M.
        • Rassy E.
        • Heudel P.E.
        • Levy C.
        • Vanlemmens L.
        • et al.
        Multicenter evaluation of breast cancer patients’ satisfaction and experience with oncology telemedicine visits during the COVID-19 pandemic.
        Br J Cancer. 2021; 125: 1486-1493
        • Davis S.W.
        • Oakley-Girvan I.
        Achieving value in mobile health applications for cancer survivors.
        J Cancer Surviv. 2017; 11: 498-504
        • Steele-Gray C.
        • Miller D.
        • Kuluski K.
        • Cott C.
        Tying ehealth tools to patient needs: exploring the use of ehealth for community-dwelling patients with complex chronic disease and disability.
        JMIR Res Protoc. 2014; 3e67
        • O’Malley D.M.
        • Davis S.N.
        • Amare R.
        • Sanabria B.
        • Sullivan B.
        • Devine K.A.
        • et al.
        Development and usability testing of the e-EXCELS tool to guide cancer survivorship follow-up care.
        Psycho-Oncology. 2020; 29: 123-131
        • Welch W.A.
        • Solk P.
        • Auster-Gussman L.
        • Gavin K.L.
        • Whitaker M.
        • Cullather E.
        • et al.
        User-centered development of a smartphone application (Fit2Thrive) to promote physical activity in breast cancer survivors.
        Transl Behav Med. 2022; 2: 203-213
        • Leach C.R.
        • Diefenbach M.A.
        • Fleszar S.
        • Alfano C.M.
        • Stephens R.L.
        • Riehman K.
        • et al.
        A user centered design approach to development of an online self-management program for cancer survivors: springboard beyond cancer.
        Psycho-Oncology. 2019; 28: 2060-2067
        • Sungur H.
        • Yılmaz N.G.
        • Chan B.M.C.
        • van den Muijsenbergh M.E.T.C.
        • van Weert J.C.M.
        • Schouten B.C.
        Development and evaluation of a digital intervention for fulfilling the needs of older migrant patients with cancer: user-centered design approach.
        JMIR Med Inform. 2020; 22e21238
        • Pruchno R.
        Technology and aging: an evolving partnership.
        Gerontologist. 2019; 59: 1-5
        • Cox A.
        • Lucas G.
        • Marcu A.
        • Piano M.
        • Grosvenor W.
        • Mold F.
        • et al.
        Cancer survivors’ experience with telehealth: a systematic review and thematic synthesis.
        JMIR Med Inform. 2017; 19e11
        • Cimperman M.
        • Brenčič M.M.
        • Trkman P.
        • Stanonik M.D.L.
        Older adults’ perceptions of home telehealth services.
        Telemed J E Health. 2013; 19: 786-790
        • Cajita M.I.
        • Hodgson N.A.
        • Lam K.W.
        • Yoo S.
        • Han H.R.
        Facilitators of and barriers to mhealth adoption in older adults with heart failure.
        Comput Inform Nurs. 2018; 36: 376-382
        • Viers B.R.
        • Pruthi S.
        • Rivera M.E.
        • O’neil D.A.
        • Gardner M.R.
        • Jenkins S.M.
        • et al.
        Are patients willing to engage in telemedicine for their care: a survey of preuse perceptions and acceptance of remote video visits in a urological patient population.
        Urology. 2015; 85: 1233-1239
        • Sanders E.
        • Stappers P.J.
        Co-creation and the new landscapes of design.
        CoDesign. 2008; 4: 5-18
        • Merkel S.
        • Kucharski A.
        Participatory design in gerontechnology: a systematic literature review.
        Gerontologist. 2019; 59: e16-e25
        • Smith J.A.
        Semi structured interviewing and qualitative analysis.
        in: Smith J.A. Harre R. Van Langenhove L. Rethinking methods in psychology. Sage Publications, 1995: 9-26
        • ResearchMatch
        ResearchMatch.
        ([accessed 18 May 2022])
        • Guest G.
        • Bunce A.
        • Johnson L.
        How many interviews are enough? An experiment with data saturation and variability.
        Field Methods. 2006; 18: 59-82
        • Kuzel A.J.
        Sampling in qualitative inquiry.
        in: Crabtree B.F. Miller W.L. Doing qualitative research. Sage Publications, Inc, Thousand Oaks, CA, US1992: 31-44
        • REDCap
        Research electronic data capture.
        ([accessed 18 May 2022])
        • Braun V.
        • Clark V.
        Using thematic analysis in psychology.
        Qual Res Psychol. 2006; 3: 77-101
        • Glaser B.G.
        • Strauss A.L.L.
        The discovery of grounded theory: strategies for qualitative research.
        Transaction Publishers, Piscataway, NJ2012
        • Fitch M.I.
        • Nicoll I.
        • Lockwood G.
        • Newton L.
        • Strohschein F.J.
        Improving survivorship care: perspectives of cancer survivors 75 years and older.
        J Geriatr Oncol. 2021; 12: 453-460
        • Centers for Disease Control and Prevention
        Telemedicine use: household pulse survey.
        ([accessed 18 May 2022])
        • Magnuson A.
        • Sattar S.
        • Nightingale G.
        • Saracino R.
        • Skonecki E.
        • Trevino K.M.
        A practical guide to geriatric syndromes in older adults with cancer: a focus on falls, cognition, polypharmacy, and depression.
        Am Soc Clin Oncol Educ Book. 2019; : e96-e109
        • Chan R.J.
        • Crichton M.
        • Crawford-Williams F.
        • Agbejule O.A.
        • Yu K.
        • Hart N.H.
        • et al.
        The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews.
        Ann Oncol. 2021; 32: 1552-1570
        • Smith A.C.
        • Thomas E.
        • Snoswell C.L.
        • Haydon H.
        • Mehrotra A.
        • Clemensen J.
        • et al.
        Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19).
        J Telemed Telecare. 2020; 26: 309-313
        • Monaghesh E.
        • Hajizadeh A.
        The role of telehealth during COVID-19 outbreak: a systematic review based on current evidence.
        BMC Public Health. 2020; 20: 1-9
        • Zhu D.
        • Paige S.R.
        • Slone H.
        • Gutierrez A.
        • Lutzky C.
        • Hedriana H.
        • et al.
        Exploring telemental health practice before, during, and after the COVID-19 pandemic.
        J Telemed Telecare. 2021; : 1-7
        • Zhou X.
        • Snoswell C.L.
        • Harding L.E.
        • Bambling M.
        • Edirippulige S.
        • Bai X.
        • et al.
        The role of telehealth in reducing the mental health burden from COVID-19.
        Telemed J E Health. 2020; 26: 377-379
        • Kim J.
        Customers’ value co-creation with healthcare service network partners.
        J Serv Theory Pract. 2019; 29: 309-328
        • Krok-Schoen J.L.
        • Pisegna J.L.
        • Brintzenhofeszoc K.
        • Mackenzie A.R.
        • Canin B.
        • Plotkin E.
        • et al.
        Experiences of healthcare providers of older adults with cancer during the COVID-19 pandemic.
        J Geriatr Oncol. 2021; 12: 190-195
        • Lam K.
        • Lu A.D.
        • Shi Y.
        • Covinsky K.E.
        Assessing telemedicine unreadiness among older adults in the United States during the COVID-19 pandemic.
        JAMA Intern Med. 2020; 180: 1389-1391