Patterns of Technology Use Among Patients With Head and Neck Cancer and Implications for Telehealth

Abstract

Objective To describe baseline technology use within the head and neck cancer (HNC) population prior to the COVID-19 pandemic. Study Design Cross-sectional analysis of National Health Interview Survey (NHIS) data. Setting The NHIS is a survey of population health administered in person annually to a nationally representative sample of noninstitutionalized US residents via a complex clustered sampling design. Methods Data regarding technology use, cancer history, and demographics were extracted from the NHIS. The study population comprised individuals who completed the NHIS Sample Adult survey from 2012 to 2018 and self-reported a cancer diagnosis. Poisson regression was used to evaluate associations between demographics and general or health-related technology use and prevalence ratios reported. Results Patients with HNC were less likely to use general technology (computers, internet, or email) when compared with other patients with cancer (60% vs 73%, P < .001), although this difference was not statistically significant after controlling for sociodemographic factors. Among patients with HNC, older age, lower education, and lower income were negatively associated with general technology use (adjusted prevalence ratio [aPR], 0.71 [95% CI, 0.59-0.87] for age 65-79 years vs <50 years; aPR, 0.66 [95% CI, 0.51-0.85] for high school vs master; aPR, 0.66 [95% CI, 0.48-0.91] for income 100%-200% vs >400% federal poverty level). Older age and lower education were negatively associated with health-related technology use (aPR, 0.46 [95% CI, 0.32-0.67] for age 65-79 years vs <50 years; aPR, 0.47 [95% CI, 0.30-0.74] for high school vs master). Conclusion Socioeconomic disparities exist in technology use rates among patients with HNC. Access to technology may pose a barrier to telehealth visits for many patients with HNC due to the unique socioeconomic demographics of this patient population.

Patient experience of telehealth appointments in head and neck cancer services during the COVID‐19 pandemic

“…The majority of participants had access to a device that allowed them to attend their telehealth appointments, with a minority requiring support to use this. This indicates that although studies have shown HNC patients to be less likely to use general technology (Warinner et al., 2021), this patient group is able to access telehealth appointments and therefore should be offered this option as part of their care pathway.…”

“…Warinner et al. (2021) explored baseline technology use within the HNC population before the COVID‐19 pandemic. They found that this patient group were less likely to use general technology (computers, internet or email) when compared with other patients with cancer, although this difference was not statistically significant.…”

Neuroethics in the Era of Teleneurology

“…If not proactively addressed, these disparities may preclude equitable access to teleneurology services across diverse populations and potentially exacerbate pre-existing health care inequalities, particularly among underserved minority populations, elderly patients, and patients with low health literacy or digital literacy. 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 It is estimated that over one in four Americans lack access to requisite technologies or digital literacy to engage in telemedicine visits, raising concerns that patients who are most vulnerable and in need of enhanced health care access may be the ones who are least likely to benefit from the advent of telemedicine technologies. 90 These issues are further magnified in considering access to teleneurology in less developed countries.…”

Informing the development of an online resource for patients with oral cancer: triangulation of qualitative data from patients and healthcare professionals

“…Increasingly, patients are looking to the internet for information, exploring it in their own time and at their own pace (2). Additionally, the current global pandemic has illustrated how technology can be used to support patients through virtual clinics, technology apps, and obtaining pre-and posttreatment information online (3)(4)(5)(6).…”