Remote electronic patient reported outcomes may have limited feasibility in older patients with cancer

1. Among patients on anticancer treatment with malignancy who were 75 years of age or older, the use of remote electronic patient-reported outcomes for monitoring had limited feasibility.

2. Feasibility was increased when considering only the subgroup of patients who agreed to test the web application, and not including the patients who declined.

Evidence Rating Level: 2 (Good)

In recent years, the use of telemedicine has expanded dramatically. Along with this has come many questions inquiring as to the efficacy of telemedicine and its feasibility. While the use of electronic patient-reported outcomes (ePROs) have been found to improve overall survival and quality of life in patients with cancer, there is a lack of data involving the feasibility of such technologies in patients who are 75 years of age or older. This multicenter prospective study therefore sought to investigate the feasibility of ePRO follow-up in patients with cancer aged 75 years or older. 473 patients (median age, 79 years [Q1-Q3 = 77-82]) within this age range who were on anticancer therapy for active malignancy were enrolled and asked to use the web-based application, ANA, for monitoring of their symptoms throughout their treatment. Those who declined were placed in the primary failure group while those who agreed were placed in the intent to treat (ITT) group. Feasibility was defined by the number of users who were active or used ANA at least once. The overall feasibility for the study population was 26%, but was higher at 66% when examining only the ITT group. Factors involved in primary failure included socioprofessional category, as univariate and multivariate analysis determined that the ITT population was significantly from a higher socioprofessional category (P = 0.002, P = 0.009 respectively). The ITT population also felt in better general condition according to the Geriatric 8-score (P = 0.002). Overall, this study found that the use of ePROs for symptom monitoring in patients 75 years or older has limited feasibility, which may be impacted by factors influencing compliance rate such as socioprofessional category.

Click to read the study in the Journal of Clinical Oncology

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