ASCO 2013: Technology speaks to adolescents in their own language
Adolescent and young adult cancer survivors between 15 and 39 years of age have unique health care needs, from difficulty accessing care to cognitive problems that linger long after treatment. Yet, communication barriers sometimes prevent them from getting the care they need in a timely way.
Using technology that this population already embraces, Jonathan Espenschied, M.D., director of Graduate Medical Education & Clinical Training, and his colleagues are trying to dissolve those barriers.
They created a tailored touchscreen tool for cancer patients and survivors in an effort to foster better communication between them and their health care team – and enable more timely intervention. Through this screening/assessment tool, called AYATT (for Adolescents and Young Adults Touchscreen Tool), clinicians will know sooner about patients’ possible cognitive issues, such as impaired motor skills or memory deficits. Those problems can then be further addressed using more in-depth clinical tools, Espenschied said.
“Using technology in the AYA population is ideal,” said Espenschied. The touch screen tool also should appeal to clinicians, he added. “One of the beauties of this is that some of these validated measures need to have calculated statistics. We built that all into the software so everything’s calculated for you. It generates clinical data faster than any person could, and a report that can be reviewed by the patient’s health care team.”
Patients completed the surveys on an iPad, yet the Web-based platform is designed also to work on other mobile devices. Espenschied assumed this platform would resonate with adolescents and young adults, yet even he was surprised at how well it was received.
“Their communication is very different from children or adults,” said Espenschied of these patients. “At a time when autonomy and self-development are at the forefront of their lives, they often don’t open up or express needs to family or physicians. Throw oncology into the mix and it really disrupts a lot of things, clinically and developmentally.”
The participants in this feasibility study “perceived this as an effective way of communicating with their health care team and [it] helped them recall issues they wanted to discuss.”
Based on patient responses, the AYATT helped 52 percent remember issues they had, or have, with their care or treatment; 39 percent were encouraged to discuss medical issues with their care team that they might not have discussed; 92 percent found it a useful way to communicate with their health care team; and 98 percent would recommend that other patients use AYATT, according to Espenschied.
Fifty-four patients receiving treatment and follow-up care for oncologic or hematologic disease participated in this study which was done over a two-month period. Patients ranging in age from 15 to 39 years of age (with an average age of 26) completed a concise AYATT battery, mostly validated, standardized measures, assessing access to care, needs, neurocognitive function and other quality-of-life issues.
Espenschied is enthusiastic about the future of this clinical tool, and believes this study’s success supports the need for further exploration of this technology and continued use in the AYA clinic and patient care setting. He believes this tool eventually can incorporate other validated clinical measures.
“Technology is at a point where the sky’s the limit. Use of these types of tools especially in the AYA population, is really only limited to your imagination,” he said.