PDF(Pubmed)
Abstract：
Despite the benefits of digital health technology use, older adults with cancer (ie, aged 65 years) have reported challenges to technology adoption. However, there has been a lack of a good understanding of their digital health technology use patterns and the associated influential factors in the past few years.
This study aimed to examine the trends in and factors associated with digital health technology use among older adults with cancer.
The National Health and Aging Trends Study (NHATS) data set is a national longitudinal cohort study with annual survey waves of Medicare beneficiaries 65 years and older. Participants were community-dwelling older adults who self-reported previous or current cancer diagnoses in each round. The study sample size of each round ranged from 1996 (2015) to 1131 (2021). Digital health technology use was defined as using the internet or online in the last month to order or refill prescriptions, contact medical providers, handle Medicare or other insurance matters, or get information about their health conditions. The association of sociodemographics, clinical factors (self-rated health, chronic conditions, difficulties in activities of daily living, dementia, anxiety, and depression), and physical function (Short Physical Performance Battery and grip strength) with digital health technology use was examined using design-based logistic regression. All statistical analyses accounted for the complex sample design.
The prevalence of any digital health technology use increased from 36% in 2015 to 45% in 2019. In 2020-2021, which was amid the COVID-19 pandemic, it ranged from 51% to 52%. In terms of each digital health technology use behavior, in 2015, overall, 28% of older cancer survivors used digital health technology to obtain health information, followed by contacting clinicians (19%), filling prescriptions (14%), and handling insurance (11%). Greater use of digital health technology was associated with younger age, being White, having a college or higher education, having a higher income, having more comorbidities, nondementia, and having a higher gait speed.
Digital health technology use in older adults with cancer has gradually increased, particularly during the COVID-19 pandemic. However, socioeconomic and racial disparities have remained in older cancer survivors. Additionally, older adults with cancer may have some unique features associated with digital health technology use; for example, their use of digital health may be increased by their comorbidities (ie, health care needs) and reduced by their frailty.
This study aimed to examine the trends in and factors associated with digital health technology use among older adults with cancer.
The National Health and Aging Trends Study (NHATS) data set is a national longitudinal cohort study with annual survey waves of Medicare beneficiaries 65 years and older. Participants were community-dwelling older adults who self-reported previous or current cancer diagnoses in each round. The study sample size of each round ranged from 1996 (2015) to 1131 (2021). Digital health technology use was defined as using the internet or online in the last month to order or refill prescriptions, contact medical providers, handle Medicare or other insurance matters, or get information about their health conditions. The association of sociodemographics, clinical factors (self-rated health, chronic conditions, difficulties in activities of daily living, dementia, anxiety, and depression), and physical function (Short Physical Performance Battery and grip strength) with digital health technology use was examined using design-based logistic regression. All statistical analyses accounted for the complex sample design.
The prevalence of any digital health technology use increased from 36% in 2015 to 45% in 2019. In 2020-2021, which was amid the COVID-19 pandemic, it ranged from 51% to 52%. In terms of each digital health technology use behavior, in 2015, overall, 28% of older cancer survivors used digital health technology to obtain health information, followed by contacting clinicians (19%), filling prescriptions (14%), and handling insurance (11%). Greater use of digital health technology was associated with younger age, being White, having a college or higher education, having a higher income, having more comorbidities, nondementia, and having a higher gait speed.
Digital health technology use in older adults with cancer has gradually increased, particularly during the COVID-19 pandemic. However, socioeconomic and racial disparities have remained in older cancer survivors. Additionally, older adults with cancer may have some unique features associated with digital health technology use; for example, their use of digital health may be increased by their comorbidities (ie, health care needs) and reduced by their frailty.
摘要：
背景：尽管使用数字健康技术有好处，患有癌症的老年人（即，65岁)报告了技术采用面临的挑战。然而,在过去的几年中，人们对他们的数字健康技术使用模式和相关影响因素缺乏很好的了解。
目的：本研究旨在研究老年人癌症患者使用数字健康技术的趋势和相关因素。
方法：国家健康与老龄化趋势研究（NHATS）数据集是一项全国性的纵向队列研究，对65岁及以上的医疗保险受益人进行年度调查。参与者是社区居住的老年人，他们在每一轮中自我报告以前或现在的癌症诊断。每轮研究的样本量从1996年(2015年)到1131年(2021年)不等。数字健康技术的使用被定义为在上个月使用互联网或在线订购或补充处方，联系医疗服务提供者，处理医疗保险或其他保险事宜，或获取有关其健康状况的信息。社会人口统计学协会，临床因素(自评健康状况，慢性疾病,日常生活活动中的困难，痴呆症,焦虑,和抑郁)，使用基于设计的逻辑回归检查了使用数字健康技术的身体功能（短物理性能电池和握力）。所有统计分析都考虑了复杂的样本设计。
结果：任何数字健康技术使用的患病率从2015年的36％增加到2019年的45％。在COVID-19大流行期间的2020-2021年，从51%到52%不等。就每个数字健康技术使用行为而言，2015年，总体而言，28%的老年癌症幸存者使用数字健康技术来获取健康信息。其次是联系临床医生(19%)，配药处方(14%)，并办理保险（11%）。数字健康技术的更多使用与年轻年龄有关，是白色的,有大学或高等教育，有更高的收入，有更多的合并症，非痴呆,有更高的步态速度。
结论：数字健康技术在老年癌症患者中的使用逐渐增加，特别是在COVID-19大流行期间。然而,老年癌症幸存者的社会经济和种族差异仍然存在。此外,患有癌症的老年人可能有一些与数字健康技术使用相关的独特特征；例如，他们对数字健康的使用可能会因他们的合并症而增加(即，医疗保健需求)，并因其虚弱而减少。
目的：本研究旨在研究老年人癌症患者使用数字健康技术的趋势和相关因素。
方法：国家健康与老龄化趋势研究（NHATS）数据集是一项全国性的纵向队列研究，对65岁及以上的医疗保险受益人进行年度调查。参与者是社区居住的老年人，他们在每一轮中自我报告以前或现在的癌症诊断。每轮研究的样本量从1996年(2015年)到1131年(2021年)不等。数字健康技术的使用被定义为在上个月使用互联网或在线订购或补充处方，联系医疗服务提供者，处理医疗保险或其他保险事宜，或获取有关其健康状况的信息。社会人口统计学协会，临床因素(自评健康状况，慢性疾病,日常生活活动中的困难，痴呆症,焦虑,和抑郁)，使用基于设计的逻辑回归检查了使用数字健康技术的身体功能（短物理性能电池和握力）。所有统计分析都考虑了复杂的样本设计。
结果：任何数字健康技术使用的患病率从2015年的36％增加到2019年的45％。在COVID-19大流行期间的2020-2021年，从51%到52%不等。就每个数字健康技术使用行为而言，2015年，总体而言，28%的老年癌症幸存者使用数字健康技术来获取健康信息。其次是联系临床医生(19%)，配药处方(14%)，并办理保险（11%）。数字健康技术的更多使用与年轻年龄有关，是白色的,有大学或高等教育，有更高的收入，有更多的合并症，非痴呆,有更高的步态速度。
结论：数字健康技术在老年癌症患者中的使用逐渐增加，特别是在COVID-19大流行期间。然而,老年癌症幸存者的社会经济和种族差异仍然存在。此外,患有癌症的老年人可能有一些与数字健康技术使用相关的独特特征；例如，他们对数字健康的使用可能会因他们的合并症而增加(即，医疗保健需求)，并因其虚弱而减少。
