Age Is Not a Barrier: Older Adults With Cancer Derive Similar Benefit in a Randomized Controlled Trial of a Remote Symptom Monitoring Intervention Compared With Younger Adults

Abstract

This study investigated a remote symptom monitoring intervention to examine if older participants with cancer received a similar magnitude of benefit compared with younger adults with cancer. We analyzed a longitudinal symptom monitoring intervention for 358 participants beginning a new course of chemotherapy treatment in community and academic oncology practices. The study design was a randomized control trial; participants were randomized to the intervention or usual care, the intervention was delivered during daily automated coaching. Older adults with moderate and severe symptoms derived similar benefit as those adults younger than 60 years of age, adherence to the study protocol which involved daily calls was high. There was no significant difference between the 2 age categories; on average, older adult participants made 88% of expected daily calls and younger adult participants made 90% of expected daily calls. Our results challenge the perception that older adults are unwilling or unable to use a technological tool such as interactive voice response and suggest that patient utilization may be guided by other factors, such as ease of use and perceived benefit from the intervention.

Challenges and Opportunities in Designing and Deploying Remote Health Monitoring Technology for Older Adults With Cancer

“…It is wrong to assume that older adults are unable or unwilling to use RHM, or that they will derive less benefit from such technology ( 25 ) . However, older adult interest and use of RHM will be lower if platforms do not adequately account for expected developmental needs.…”

Digital Phenotyping of Behavioral Symptoms as the Next Frontier for Personalized and Proactive Cancer Care

“…The term digital phenotyping encapsulates a range of approaches that include ecological momentary assessment, actigraphy, global positioning system, natural language processing (NLP), and computer-based cognitive testing and training. It has been demonstrated that these approaches can be used to reliably detect multiple depressionrelated symptoms: (1) depressed mood, (2) loss of interest or pleasure, (3) appetite/weight disturbance, (4) sleep disturbance, (5) psychomotor changes, (6) loss of energy, (7) feelings of worthlessness/guilt, (8) decreased concentration, and (9) suicidal ideation. 18 Therefore, using these technologies to identify psychiatric symptoms can contribute to personalized care approaches for patients with cancer.…”

“…5 Improved treatment-related symptom management (ie, appetite loss, fatigue, nausea, hot flashes, pain, and neuropathy) has been significantly associated with reduced acute care utilization, improved health-related quality of life, reduced health care spending, and enhanced overall survival. 6,7 Consequently, a thoughtfully implemented symptom monitoring paradigm that leverages digital phenotyping data could enhance the delivery of personalized care related to proactive and timely behavioral symptom management. In this article, we delineate a novel value proposition for digital phenotyping in cancer care via the accurate and reproducible detection of burden because of psychiatric comorbid illness, with a particular emphasis on depression.…”

Benefits, Challenges, and Opportunities of Integrating Patient-Reported Outcome Measures in Geriatric Oncology to Advance Patient Screening for Functional Fitness for Treatment

“…A common concern is that older patients will not benefit because they cannot keep up with technologyuptake, usage and adherence are seen as likely being abysmal. Perhaps some level of concern is legitimate when patient burden is taken into account, however new evidence suggests that age is not a barrier here 45 . Instead, the real challenge here is related more to limitations in resources and infrastructure to support innovation in geriatric oncology 17,45 , perhaps similar to any other area in cancer care.…”