Dr Sarah Wall: Challenges Faced by Older Patients With Hematologic Disorders

In an interview with The American Journal of Managed Care^Ⓡ, Sarah Wall, MD, assistant professor in the Division of Hematology at The Ohio State University Comprehensive Cancer Center, emphasizes the need to study treatments for different age groups, particularly focusing on older adults with hematologic disorders. Even the FDA has stressed this due to disease variations and social dynamics, she explains.

Transcript

What are some unique struggles that older adults with hematologic disorders face?

This is a really important one, and it's one that has had a lot of light shed on it recently by a number of organizations. I think one really important one, in particular, is the FDA has actually issued guidance that it's really important that we study treatments and focusing on those cohorts, in part because of some of the things we just talked about, that the diseases may behave differently.

But there's such a difference in social dynamics and engagement with the environment around them for older adults vs younger adults because the things that may often be overlooked are related to financial toxicity. Finances, for older patients, without making an overgeneralization, finances are often very different for older patients when they may be on a fixed income.

The payers are often very different for older patients when we start getting into Medicare coverage. And then, the other things that come into play that are less tangible, even, are things like where you've set up your support system, and that will differ by family. But a lot of older patients are in a setting where they've got kids or grandkids or lifelong friends and family who are around them and supporting them.

And so depending on how far away they live from a treatment center, having to uproot themselves from all of that support can be very taxing and actually sometimes make it prohibitive to get the best treatment that they could. Then there are costs with all of that, too. Gas money, hotel money, all of those things play a role and those can often be really big stressors when you also add in that piece of potentially going on a fixed income or having to dip into savings that were supposed to last well into retirement.