Utilization of technology among older Indian patients with cancer
Authors: Rao Abhijith Rajaram , Gattani Shreya , Castelino Renita , Kumar Sharath , Dhekale Ratan , Krishnamurthy Jyoti , Ramaswamy Anant , Noronha Vanita , Gota Vikram , Banavali Shripad , Badwe Rajendra A. , Prabhash Kumar 
Published: January 2022

Background:
Technology has advanced tremendously and can address the gaps in the care of older adults with cancer. Studies from high-income countries reveal that the use of technology among older adults is on the rise, but there are no published data regarding the use of technology by health-seeking older adults from India.

Objectives:
We aimed to assess the use of mobile phones, Internet, and social media applications among older adults with cancer attending a geriatric oncology clinic. We also aimed to study their association with various intrinsic factors.

Materials and Methods:
This cross-sectional study was conducted in the geriatric oncology clinic at the Tata Memorial Hospital, a tertiary care center in Mumbai, India, between April 2021 and October 2021. Participants were patients with cancer aged 60 years and over, who were referred to the geriatric oncology clinic. Clinicodemographic details were recorded, and a multi-dimensional geriatric assessment was performed. Patients were asked whether they owned and used mobile phones, Internet, E-mail, and social media applications such as WhatsApp and Facebook. The same questions regarding technology use were asked to their accompanying caregivers. Categorical variables were compared using the Fisher's exact and Pearson's Chi-squared test.

Results:
A total of 309 participants were included. The median age was 68 (interquartile range, 64–72) years; 262 (85%) participants were aged <75 years. There were 234 (76%) men in the cohort. A total of 25 (33%) women and 25 (11%) men were uneducated; 225 (81%) participants had mobile phones; and 24 (9%) had mobile phones and landlines. Female patients (59% vs. 77%, P = 0.001) and those with poor vision (67% vs. 80%, P = 0.036), no education (50% vs. 74%, P < 0.001), and impaired cognition (49% vs. 84%, P < 0.001) were less likely to own a mobile phone. A total of 70 (25%) participants reported that they accessed the Internet, but only 16 (6%) used Internet, E-mail, and social media on their own phones. Use of the Internet and social media was less likely among people with no education ([4% vs. 22%, P < 0.001] and [6% vs. 21%, P < 0.01], respectively) and impaired cognition ([5% vs. 26%, P = 0.013] and [8% vs. 28%, P = 0.022], respectively). Among accompanying caregivers, 297 (99%) reported that they used mobile phones, while 223 (75%) used E-mail and social media applications.

Conclusion:
Over 80% of older Indian adults with cancer use mobile phones, but only 25% use Internet and social media. Women and those with no education, poor vision, and impaired cognition are less likely to own a mobile phone. People with no education and impaired cognition are also less likely to use Internet and social media. Further studies are required to understand the acceptance rate and feasibility of technology use in our setting and to gather more evidence for the effectiveness of these interventions.