JMIR Publications

ABSTRACT

Background:

Despite the benefits of digital health technology use, cancer survivors, especially older cancer survivors (i.e., aged>=65) have reported challenges to technology adoption. However, there is a lack of a good understanding of their digital health technology use patterns in the past few years and influential factors.

Objective:

To examine the trends in and factors associated with digital health technology use among older cancer survivors.

Methods:

The National Health and Aging Trends Study (NHATS) dataset is an annual longitudinal, nationally representative survey data collected from Medicare beneficiaries aged 65 and older. Participants were community-dwelling older adults who self-reported previous/current cancer diagnoses from 2015 to 2021. The study sample ranged from 1,996 (2015) to 1,131 (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 socio-demographics, clinical factors (self-rated health, chronic conditions, difficulties in activities of daily living, dementia, anxiety, and depression), and physical function (Short Physical Performance Battery, grip strength) with digital health technology use were examined using multiple design-based logistic regression.

Results:

The prevalence of any digital health technology use increased from 36% in 2015 to 45% in 2019. In 2020-2021, which was amidst COVID-19, it ranged from 51% to 52%. In terms of each digital health technology use behavior, in 2015, 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, White, college or higher education, higher income, more comorbidities, non-dementia, and higher gait speed.

Conclusions:

Digital health technology use in older cancer survivors has gradually increased, particularly during the COVID-19 pandemic. However, socioeconomic and racial disparities have remained in older cancer survivors. Additionally, older cancer survivors may have some unique features associated with digital health technology use, e.g., their use of digital health may be increased by their comorbidities (i.e., healthcare needs) and reduced by their frailty. Clinical Trial: n/a