Aims: Digital health interventions(DHIs) allow patients prompt and remote access to health information and services. Since 2005, the World Health Assembly has been advocating for the development of an infrastructure to ensure equitable access to DHIs. To enable this, a comprehensive understanding of the patterns of use of DHIs amongst different patient populations is required. As little is known about the pattern of use of DHIs among older patients(≥65 years old) with cancer, our study aimed to assess barriers and enablers of uptake and adherence to DHIs among this patient population.
Methods: A systematic search was done on CINAHL, Cochrane, Emcare, JBI, MEDLINE, Proquest, and SCOPUS for English-language primary qualitative and mixed methods studies since inception until September 2021. Data was appraised using the Mixed Methods Appraisal Tool and thematic synthesis was done.
Results: Five studies comprising of 61 patients and 23 caregivers met the eligibility criteria. All studies examined barriers and enablers to uptake of DHIs but only two studies examined barriers and enablers to adherence. Two themes – usability and perceived usefulness – emerged from all analyses. High usability to uptake was facilitated by minimalist and age-appropriate design. High usability to adherence was facilitated by customisability of DHIs and availability to provide feedback on DHI design. High perceived usefulness to uptake was facilitated by DHIs’ ability to provide health information and to connect the patient to their healthcare team. High perceived usefulness to adherence was facilitated by DHIs ability to provide reminders and contingency plans, reinforce long-term treatment plans, and keep healthcare teams updated on patients’ progress.
Conclusions: The limited amount of data and similarities of the themes(usability and perceived usefulness) to other patient populations render the need for more studies to further elucidate barriers and enablers of uptake and adherence to DHIs among older patients with cancer.