Villejuif, 4 June 2024
ASCO 2024 – Clinical science symposium
Certain socio-economic factors influence adherence to a remote monitoring system
At a time when remote monitoring has demonstrated its benefits in cancerology and is being deployed, no studies have so far focused on the barriers that could prevent access for all, and in particular the role of socio-economic factors. The findings presented by Dr. Maria Alice Franzoi, an oncologist at Gustave Roussy, show that several of these factors are slowing down patients’ adherence to a remote monitoring pathway.
Abstract no. 1506 presented orally by Dr Maria Alice Franzoi on Tuesday 4 June at 11:45 a.m. UTC-5.
This oral presentation is one of the 135 presentations on the agenda for this 2024 edition of ASCO, in which Gustave Roussy’s research physicians took part, including 29 oral presentations. Gustave Roussy is present in many fields of expertise, attesting to the quality of the research carried out there and its international recognition.
Social health determinants are a concept of public health, referring to several socio-economic factors that can influence the state of health of a population, and upon which action is possible. In cancerology, these determinants are responsible for the disparities observed in access to care, adherence to treatments, severity of symptoms, and also those concerning quality of life.
No scientific studies have so far studied the impact of these social health determinants on patient adherence to a remote monitoring scheme deployed in routine care. The work presented orally this year at ASCO by Dr Maria Alice Franzoi focused on ensuring patients have fair access to remote monitoring schemes.
A study conducted in 42 French and Belgian hospitals
This work, sponsored by Gustave Roussy, was carried out in 42 French and Belgian hospitals, on nearly 2,000 patients with cancer. Within this cohort, 896 agreed to provide personal data relating to their social health determinants (income, diplomas, digital culture, etc.), of which 69% were women, with a median age of 60. The most highly represented tumour was the breast, in 49% of patients, followed by gastrointestinal tumours.
Of these nearly 900 patients, 73% reported at least one negative social health determinant, via an online questionnaire designed by the study physicians who conducted the study. 39% reported difficulties in receiving support from their loved ones, 24% reported a weak digital culture, 22% reported difficulties with their level of education, 15% reported difficulties in understanding their medical situation, and 12% reported difficulties with financial security.
An impact on remote monitoring compliance
"Data analysis shows the negative impact of social health determinants on adherence to remote monitoring. Patients who reported difficulties in understanding their treatment plan have a 10% lower remote monitoring adherence rate, and a 5% lower adherence rate when they report a weak digital culture," says Dr Maria Alice Franzoi.
At the same time, the severity of symptoms is more pronounced in patients in financial difficulties (+6%), but also in those with a poor understanding of their disease (+10%). Thus, patients for whom remote monitoring would have the most significant benefits, particularly in the management of toxicities and symptoms, are paradoxically those in whom less adherence to this scheme is observed.
"In order to reduce the disparities observed and ensure access to remote monitoring so that there is no loss of chances, early screening for negative health determinants in patients with cancer would allow us to propose adapted pathways, and thus strengthen their adherence to these monitoring technologies," concludes Dr Maria Alice Franzoi.
Abstract no. 1506 - The impact of self-reported social determinants of health (SDOH) on patient engagement and symptom burden across a remote patient monitoring (RPM) pathway in 42 European hospitals - Oral session – Tuesday 4 June 2024 | 11:45 UTC-5.
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