Acceptability of Telemedicine in a Geriatric Outpatient Practice During the COVID-19 Pandemic.

Background: Telemedicine utilization has increased dramatically during the COVID pandemic. Few studies have evaluated the use and acceptability of telemedicine in older populations. This study examined the use and acceptability of telemedicine with older adults in an urban, geriatric practice. Methods: An anonymous survey was sent to patients seen at an urban, geriatric practice using MyChart in EPIC in March 2021. This population of patients is 55 years and older, 50% Black, 40% white, 3% Latino, 3% Asian, and 4% other. This panel is comprised of 71% Medicare, 23% non-Medicare/non-Medicaid, and 6% Medicaid. The total panel of patients includes ∼1,400 patients. The percent of patients on MyChart at the time of the survey was 78%. Thus, about 1,092 patients received the survey. Results: Of the 1,092 patients who received the survey, 247 (22.6%) responded. Around 80.37% of respondents rated their overall experience with telemedicine as good or excellent. Theme areas emerged around the advantages and disadvantages of telemedicine. A majority (70.28%) of respondents rated themselves as Somewhat Confident to Very Confident in use of telemedicine without family/friend assistance. A majority (74.16%) of respondents stated they plan to use telemedicine again. Conclusions: This survey demonstrated the feasibility and acceptability of telemedicine in an urban, geriatric population. A limit to this study is that the survey was administered on-line, so that participants may be biased regarding use of online technology. However, this study showed that the vast majority of older adults were confident in using telemedicine as an alternative to in-person visits during the COVID pandemic and plan on using it again.

Polypharmacy in the Geriatric Oncology Population.

PURPOSE OF REVIEW: This review explores the multiple definitions, epidemiology, and impact of polypharmacy in geriatric oncology patients. Risk factors and clinical implications of polypharmacy are delineated and potential clinical approaches to reduce polypharmacy are reviewed. RECENT FINDINGS: Most sources currently define polypharmacy as the administration of multiple medications that are non-essential, unnecessary, duplicative, or ineffective. Possible risk factors associated with polypharmacy in geriatric cancer patients include comorbid conditions, prescribing cascades, and hospitalization. Consequences of polypharmacy in this population include adverse drug events, drug-drug interactions, reduced adherence, frailty, and increased morbidity. Clinical approaches to the reduction of polypharmacy include thorough medication histories and an interprofessional team approach to care. Polypharmacy is common and has a direct clinical impact on geriatric oncology patients. There is a clear deficit in our understanding of the scope and impact of polypharmacy in this population and only limited evaluation of various interventions exist. The paucity of information is at least partially linked to the consistent exclusion of older adults in cancer studies and the complex interaction between polypharmacy and potential morbidities/mortality.