Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing (Preprint)

Abstract

BACKGROUND Globally, cancer predominates in adults age 60+, and 70% of older adults have ≥1 chronic condition. Cancer self-management interventions can improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multi-morbidity. Despite growing evidence of digital health tools in cancer care, there is a paucity of theoretically grounded digital self-management supports for older adults. Many apps for older adults have not been co-designed with older adults to ensure they are tailored to their specific needs, which will increase usability and uptake. OBJECTIVE To design a self- and symptom-management app to support older adults living with cancer and multi-morbidities. METHODS This study used Grey’s self-management framework, a design thinking approach, and involved older adults with lived experiences of cancer to design a medium-fidelity app prototype. Older adults with cancer/caregivers were recruited through community organizations/support groups to participate in co-designing/evaluations of the app. Data from interviews was iteratively integrated into the design process and analyzed using descriptive statistics and thematic analyses. RESULTS Eighteen older adults and two caregivers (n=20); participated in the study: 10 participated (8 older adults; 2 caregivers) in the design of the low fidelity prototype and 10 evaluated (9 older adults; 1 caregiver) the medium fidelity prototype (2 older adults participated in both phases). Participants emphasized the importance of tracking functions to make sense of information across physical and psychosocial symptoms; a clear display; and the organization of notes and reminders to communicate with care providers. Participants also emphasized the importance of medication initiation/cessation reminders to mitigate concerns related to polypharmacy. CONCLUSIONS This app will support the complex healthcare needs of older adults with cancer, creating a ‘home base’ for symptom management and support. Findings from this study will position the researchers to conduct feasibility testing and real-world implementation. CLINICALTRIAL NA