Abstract A096: Smartphone use and accessibility to Internet by cancer patients in a socioeconomically diverse community

Introduction: Hospitals are increasingly using different patient engagement platforms to improve patient education, engagement, and satisfaction. Most of these patient engagement platforms are smartphone based. This requires patient awareness and understanding of basic technology. Einstein Medical Center serves a large socioeconomically and racially diverse population in North Philadelphia. We undertook a feasibility study before introducing any patient education/engagement platforms in our population. Our primary objective was to assess the use of smartphones and Internet by cancer patients in a socioeconomically diverse population. Our secondary objective was to assess feasibility of introducing technological platforms to improve patient education, engagement and satisfaction.

Methods: A onetime cross-sectional survey of patients attending the outpatient clinic and infusion center were interviewed by a trained interviewer during a one-week period in July 2018. The questionnaire was designed to assess demographic information, questions related to patients' smartphone and Internet availability, and use for health.

Results: We surveyed 75 patients in one week (N=75). Their ages ranged from 21 to 91 years old. There were 25 (33.3%) male and 50 (66.7%) female patients. Around 32 patients had at least a college education and 42 had a high school level education or less. 53 (71.6%) patients owned a smartphone and all of those owners could browse the Internet and download applications on their phone. 20 (26.67%) patients used an iPhone platform and 34 (45.33%) patients used an Android smartphone. Most of the patients who had a smartphone were willing to download applications that can help monitor their cancer and health.

Conclusion: Though our hospital is located in a socioeconomically disadvantaged area, the vast majority of patients own a smartphone and are willing to use them to monitor their cancer care. We can confidently use this technological advancement to help improve patient education, engagement, and satisfaction in this setting.

Note: This abstract was not presented at the conference.

Citation Format: Rashmika R. Potdar, Arun Thomas, Claudia Dourado, Kamran Mohiuddin, Djeneba Audrey M. Djibo, John C. Leighton, Jean G. Ford. Smartphone use and accessibility to Internet by cancer patients in a socioeconomically diverse community [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A096.

Association Between the Timing of Goals-of-Care Discussion and Hospitalization Outcomes in Patients With Metastatic Cancer

BACKGROUND

Patients with cancer often require acute hospitalizations, many of which are unplanned. These hospitalizations have been shown to increase in frequency near the end of life. The American College of Physicians recommends that goals-of-care (GOC) discussions be initiated early for metastatic cancers. We hypothesized that discussing GOC during hospitalization could help reduce readmissions. Our aim was to examine the association between the timing of GOC discussion, length of hospital stay, and the time to readmission.

METHODS

We conducted a retrospective review of medical records of patients with stage IV cancers hospitalized between August 2017 and July 2018. We recorded timing of GOC discussion, use of palliative care services, and hospital readmissions within 90 days. χ² tests were used to identify independent associations with GOC discussion, and logistic regression was used to examine association with readmission within 90 days.

RESULTS

Of all study patients (N = 241), 40.6% were female, 46% (n = 112) had a GOC discussion, and 34% (n = 82) had a palliative care consultation. Having a palliative care consult and being admitted to critical care were independently associated with having a GOC discussion. Early timing of GOC discussion was inversely associated with admission to critical care units (P < .05). Thirty-eight percent (n = 92) had unplanned hospital readmission within 90 days. Having a GOC discussion was independently associated with a reduction in the odds of an unplanned hospital readmission within 90 days by 79% (odds ratio = 0.21, 95% confidence interval: 0.12-0.37).

CONCLUSION

Among hospitalized patients with stage IV cancer, performing an early GOC discussion has an important association with lower hospital readmission rates and increased rates of goal-congruent patient care.