Enrique Soto-Perez-De-Celis1, Heeyoung Kim2, María Patricia Rojo-Castillo3, Can-Lan Sun2, Yanin Chavarri-Guerra4, Ana Patricia Navarrete-Reyes3, James R Waisman2, José Alberto Avila-Funes5, Álvaro Aguayo4, Arti Hurria2. 1. Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, CP 14080 Mexico City, Mexico; City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, United States. Electronic address: enriquesotopc@yahoo.com. 2. City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, United States. 3. Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, CP 14080 Mexico City, Mexico. 4. Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, CP 14080 Mexico City, Mexico. 5. Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, CP 14080 Mexico City, Mexico; Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, F-33000 Bordeaux, France.
Abstract
OBJECTIVES: Older adults with cancer in developing countries face challenges accessing healthcare due to a lack of personnel and infrastructure. A decline in physical activity (defined as a decrease in the number of daily steps) may be a novel method for the timely detection of toxicity in older adults receiving chemotherapy in resource-constrained settings. MATERIALS AND METHODS: In this feasibility study, patients aged ≥65years starting first-line chemotherapy for solid tumors were given a smartphone with a pedometer application. Daily steps were monitored daily for one cycle. If a ≥15% decrease from baseline was identified, the patient was called and the presence of toxicity assessed. The intervention would be feasible if ≥75% of the subjects recorded steps for ≥75% of the planned chemotherapy days. RESULTS: Forty patients (median age 73; 57% [N=23] female) were included. Seventy percent (N=28) had stage III-IV disease with 45% (N=18) gastrointestinal, 23% (N=9) breast, and 32% (N=13) other malignancies. Mean pre-treatment daily steps was 3111 (Standard Deviation [SD] 1731), and median follow-up was 21days (range 2-28). Despite having limited exposure to mobile technology, most (93%) patients used the smartphone appropriately, and 85% found it easy to use. Sixty percent of patients (N=24) had toxicities managed over the phone, 27.5% (N=10) were sent for urgent medical attention and 15% (N=6) were hospitalized. CONCLUSION: Using smartphones to monitor older adults with cancer receiving chemotherapy in a resource-constrained setting is feasible and acceptable. A decrease in the number of daily steps was common and helped to identify chemotherapy toxicity.
OBJECTIVES: Older adults with cancer in developing countries face challenges accessing healthcare due to a lack of personnel and infrastructure. A decline in physical activity (defined as a decrease in the number of daily steps) may be a novel method for the timely detection of toxicity in older adults receiving chemotherapy in resource-constrained settings. MATERIALS AND METHODS: In this feasibility study, patients aged ≥65years starting first-line chemotherapy for solid tumors were given a smartphone with a pedometer application. Daily steps were monitored daily for one cycle. If a ≥15% decrease from baseline was identified, the patient was called and the presence of toxicity assessed. The intervention would be feasible if ≥75% of the subjects recorded steps for ≥75% of the planned chemotherapy days. RESULTS: Forty patients (median age 73; 57% [N=23] female) were included. Seventy percent (N=28) had stage III-IV disease with 45% (N=18) gastrointestinal, 23% (N=9) breast, and 32% (N=13) other malignancies. Mean pre-treatment daily steps was 3111 (Standard Deviation [SD] 1731), and median follow-up was 21days (range 2-28). Despite having limited exposure to mobile technology, most (93%) patients used the smartphone appropriately, and 85% found it easy to use. Sixty percent of patients (N=24) had toxicities managed over the phone, 27.5% (N=10) were sent for urgent medical attention and 15% (N=6) were hospitalized. CONCLUSION: Using smartphones to monitor older adults with cancer receiving chemotherapy in a resource-constrained setting is feasible and acceptable. A decrease in the number of daily steps was common and helped to identify chemotherapy toxicity.
Authors: Anabela G Silva; Patrícia Simões; Rita Santos; Alexandra Queirós; Nelson P Rocha; Mário Rodrigues Journal: J Med Internet Res Date: 2019-11-15 Impact factor: 5.428