1
|
Holland AE, Woollett A, Goh N, Glaspole I. Respiratory teletrials-A call for equitable access to clinical trials for people with respiratory conditions. Respirology 2024. [PMID: 38924193 DOI: 10.1111/resp.14781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024]
Affiliation(s)
- Anne E Holland
- Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
| | - Anne Woollett
- TrialHub, Alfred Health, Melbourne, Victoria, Australia
| | - Nicole Goh
- Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Victoria, Australia
- Institute for Breathing and Sleep, Heidelberg, Victoria, Australia
- Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Victoria, Australia
| | - Ian Glaspole
- Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Victoria, Australia
- School of Translational Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Symons T, Woollett A, Zalcberg J, Eckstein L. Implementing Decentralized Clinical Trials in Australia through Teletrials: Where to From Here? Ther Innov Regul Sci 2024:10.1007/s43441-024-00658-x. [PMID: 38683418 DOI: 10.1007/s43441-024-00658-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/12/2024] [Indexed: 05/01/2024]
Abstract
Implementation of decentralized approaches can improve access to clinical trials. The Australian government has focused on a teletrial model, which resources and upskills health care organisations to enable collaboration in trials to extend to rural and remote areas. This commentary describes the Australian teletrial model, its context within the established DCT model, its value, and likely challenges moving forward.
Collapse
Affiliation(s)
- Tanya Symons
- T Symons Associates Pty Ltd, Sydney, NSW, Australia.
| | | | - John Zalcberg
- Cancer Research Program, School of Public Health, Monash University, Clayton, Australia
- Department of Medical Oncology, Alfred Health, Melbourne, Australia
| | | |
Collapse
|
3
|
Underhill C, Freeman J, Dixon J, Buzza M, Long D, Burbury K, Sabesan S, McBurnie J, Woollett A. Decentralized Clinical Trials as a New Paradigm of Trial Delivery to Improve Equity of Access. JAMA Oncol 2024; 10:526-530. [PMID: 38358756 DOI: 10.1001/jamaoncol.2023.6565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Importance The need to maintain clinical trial recruitment during the COVID-19 pandemic has precipitated the rapid uptake of digital health for the conduct of clinical trials. Different terms are used in different jurisdictions and clinical contexts, including digital trials, networked trials, teletrials (TT), and decentralized clinical trials (DCT) with a need to agree to terms. Observations This clinical care review summarized publications and gray literature, including government policies for the safe conduct of clinical trials using digital health. It compares 2 frequently used methodologies, DCT and TT, first developed before the COVID-19 pandemic by trialists and stakeholders in Australia to improve access to cancer clinical trials for geographically dispersed populations. TT uses a networked approach to implement clinical trials to share care between facilities and uses an agreement between sites or a supervision plan to improve governance and safety. Government regulators have adapted existing regulations and invested in the rollout of the TT model. The term DCT emerged in the northern hemisphere and has been the subject of guidance from regulatory agencies. DCT uses digital health to deliver care in nontraditional sites, such as participants' homes, but does not mandate a networked approach between health facilities or require a supervision plan to be in place. Conclusions and Relevance TT can be considered as a specific type of DCT with several potential advantages, including upskilling across a network. DCT is a new paradigm for the use of digital health in the safe conduct of clinical trials and is a transformative issue in cancer care, addressing disparities in access to clinical trials and improving clinical outcomes.
Collapse
Affiliation(s)
- Craig Underhill
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
- University of NSW Rural Medical School, Albury, New South Wales, Australia
| | - Jessica Freeman
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
| | | | - Mark Buzza
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
| | - Donna Long
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
| | - Kate Burbury
- Victorian Comprehensive Cancer Center Alliance, Parkville, Victoria, Australia
- University of Melbourne, Parkville, Victoria, Australia
- Peter MacCallum Cancer Centre Parkville, Victoria, Australia
| | - Sabe Sabesan
- James Cook University, Townsville, Queensland, Australia
- Townsville University Hospital, Townsville, Queensland, Australia
| | - Jacqueline McBurnie
- Border Medical Oncology Research Unit, Albury Wodonga Regional Cancer Centre, Albury, New South Wales, Australia
| | | |
Collapse
|
4
|
Nanavati HD, Andrabi M, Arevalo YA, Liu E, Shen J, Lin C. Disparities in Race and Ethnicity Reporting and Representation for Clinical Trials in Stroke: 2010 to 2020. J Am Heart Assoc 2024; 13:e033467. [PMID: 38456461 PMCID: PMC11010007 DOI: 10.1161/jaha.123.033467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/16/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Racial and ethnic minority groups are at a higher stroke risk and have poor poststroke outcomes. The aim of this study was to assess the frequency of race reporting and proportions of race and ethnicity representation in stroke-related clinical trials. METHODS AND RESULTS This is a descriptive study of stroke-related clinical trials completed between January 1, 2010 and December 31, 2020, and registered on ClinicalTrials.gov. Trials conducted in the United States, related to stroke and enrolling participants ≥18 years, were considered eligible. Trials were reviewed for availability of published results, data on race and ethnicity distribution, and trial characteristics. Overall, 60.1% of published trials reported race or ethnicity of participants, with a 2.6-fold increase in reporting between 2010 and 2020. White patients represented 65.0% of the participants, followed by 24.8% Black, 2.4% Asian or Pacific Islander, and <1% Native American and multiracial participants; 9.0% were of Hispanic ethnicity. These trends remained consistent throughout the study period, except in 2018, when a higher proportion of Black participants (53.1%) was enrolled compared with White participants (35.8%). Trials with the National Institutes of Health/federal funding had higher enrollment of Black (28.1%) and Hispanic (13.8%) participants compared with other funding sources. Behavioral intervention trials had the most diverse enrollment with equal enrollment of Black and White participants (41.1%) and 14.5% Hispanic participants. CONCLUSIONS Despite the increase in race and ethnicity reporting between 2010 and 2020, the representation of racial and ethnic minority groups remains low in stroke trials. Funding initiatives may influence diversity efforts in trial enrollment.
Collapse
Affiliation(s)
- Hely D. Nanavati
- Department of EpidemiologyThe University of Alabama at BirminghamBirminghamAL
| | - Mudasir Andrabi
- Capstone College of NursingThe University of AlabamaTuscaloosaAL
| | - Yurany A. Arevalo
- Department of NeurologyThe University of Alabama at BirminghamBirminghamAL
| | - Evan Liu
- Heersink School of MedicineThe University of Alabama at BirminghamBirminghamAL
| | - Jeffrey Shen
- Department of RheumatologyDuke UniversityDurhamNC
| | - Chen Lin
- Department of NeurologyThe University of Alabama at BirminghamBirminghamAL
- Birmingham VA Medical CenterBirminghamAL
| |
Collapse
|
5
|
Alexander M, Collins I, Abraham P, Underhill C, Harris S, Torres J, Sharma S, Solomon B, Tran‐Duy A, Burbury K. Telehealth in oncology: a cost analysis to evaluate the financial impact of implementing regional trial hubs within a phase 3 cancer clinical trial. Intern Med J 2023; 53:2346-2349. [PMID: 38130050 PMCID: PMC10946773 DOI: 10.1111/imj.16292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
This cost analysis, from a societal perspective, compared the cost difference of a networked teletrial model (NTTM) with four regional hubs versus conventional trial operation at a single metropolitan specialist centre. The Australian phase 3 cancer interventional randomised controlled trial included 152 of 328 regional participants (patient enrolment 2018-2021; 6-month primary end point). The NTTM significantly reduced (AU$2155 per patient) patient travel cost and time and lost productivity.
Collapse
Affiliation(s)
- Marliese Alexander
- Pharmacy DepartmentPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
| | - Ian Collins
- Victorian Comprehensive Cancer CentreMelbourneVictoriaAustralia
- Deakin UniversityMelbourneVictoriaAustralia
| | - Patrick Abraham
- Centre for Health Policy, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Craig Underhill
- Border Medical Oncology and Haematology Research UnitAlbury Wodonga Regional Cancer CentreAlbury WodongaNew South WalesAustralia
- Rural Medical SchoolUniversity of New South WalesSydneyNew South WalesAustralia
| | - Sam Harris
- Bendigo Cancer CentreBendigo HealthBendigoVictoriaAustralia
| | - Javier Torres
- Peter Copulos Cancer and Wellness CentreGoulburn Valley HealthSheppartonVictoriaAustralia
- Shepparton Clinical SchoolThe University of MelbourneSheppartonVictoriaAustralia
| | - Sharad Sharma
- Ballarat Regional Integrated Cancer CentreGrampians HealthBallaratVictoriaAustralia
| | - Benjamin Solomon
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
- Department of Medical OncologyPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - An Tran‐Duy
- Centre for Health Policy, Melbourne School of Population and Global HealthThe University of MelbourneMelbourneVictoriaAustralia
| | - Kate Burbury
- Sir Peter MacCallum Department of OncologyThe University of MelbourneMelbourneVictoriaAustralia
- Department of HaematologyPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| |
Collapse
|
6
|
Andriani L, Oh J, McMinn E, Gleason E, Koelper NC, Chittams J, Simpkins F, Ko EM. Telehealth utilization in gynecologic oncology clinical trials. Gynecol Oncol 2023; 177:103-108. [PMID: 37659265 PMCID: PMC10591867 DOI: 10.1016/j.ygyno.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/15/2023] [Accepted: 08/20/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE Prior to the COVID-19 pandemic, telehealth visits and remote clinical trial operations (such as local collection of laboratory tests or imaging studies) were underutilized in gynecologic oncology clinical trials. Current literature on these operational changes provides anecdotal experience and expert opinion with few studies describing patient-level safety data. We aimed to evaluate the safety and feasibility of telehealth and remote clinical trial operations during the COVID-19 Pandemic. METHODS Gynecologic oncology patients enrolled and actively receiving treatment on a clinical trial at a single, academic institution during the designated pre-Telehealth and Telehealth periods were identified. Patients with at least 1 provider or research coordinator telehealth visit were included. Patient demographics, health system encounters, adverse events, and protocol deviations were collected. Pairwise comparisons were performed between the pre-Telehealth and Telehealth period with each patient serving as their own control. RESULTS Thirty-one patients met inclusion criteria. Virtual provider visits and off-site laboratory testing increased during the Telehealth period. Delays in provider visits, imaging, and laboratory testing did not differ between time periods. Total and minor protocol deviations increased in incidence during the Telehealth period and were due to documentation of telehealth and deferment of non-therapeutic testing. Major protocol deviations, emergency department visits, admissions, and severe adverse events were of low incidence and did not differ between time periods. CONCLUSIONS Telehealth and remote clinical trial operations appeared safe and did not compromise clinical trial protocols in a small, single institutional study. Larger scale evaluations of such trial adaptations should be performed to determine continued utility following the Pandemic.
Collapse
Affiliation(s)
- Leslie Andriani
- Division of Gynecologic Oncology at Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jinhee Oh
- Brigham Obstetrics and Gynecology Group, Foxborough, MA, United States of America
| | - Erin McMinn
- Division of Gynecologic Oncology, Columbia University Irving Medical Center, New York, NY, United States of America
| | - Emily Gleason
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States of America
| | - Nathanael C Koelper
- Women's Health Clinical Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jesse Chittams
- Women's Health Clinical Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Fiona Simpkins
- Division of Gynecologic Oncology at Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Emily M Ko
- Division of Gynecologic Oncology at Penn Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America; Penn Center for Cancer Care Innovation, Abramson Cancer Center, University of Pennsylvania Health Systems, Philadelphia, PA, United States of America.
| |
Collapse
|
7
|
Ducrocq Q, Guédon-Moreau L, Launay D, Terriou L, Morell-Dubois S, Maillard H, Lefèvre G, Sobanski V, Lambert M, Yelnik C, Farhat MM, Garcia Fernandez MJ, Hachulla E, Sanges S. Activities of Clinical Expertise and Research in a Rare Disease Referral Centre: A Place for Telemedicine beyond the COVID-19 Pandemic? Healthcare (Basel) 2023; 11:2447. [PMID: 37685481 PMCID: PMC10487162 DOI: 10.3390/healthcare11172447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 08/26/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023] Open
Abstract
INTRODUCTION Rare disease referral centres are entrusted with missions of clinical expertise and research, two activities that have to contend with numerous obstacles. Providing specialist opinions is time-consuming, uncompensated and limited by difficulties in exchanging medical data. Clinical research is constrained by the need for frequent research protocol visits. Our objective was to determine whether telemedicine (TLM) can overcome these difficulties. METHODS To better characterise the activity of clinical expertise provided by our French centre, each opinion delivered by our team was reported on a standardised form. To investigate our clinical research activity, investigators and patients were asked to complete a questionnaire on the acceptability of research protocol teleconsultations. RESULTS Regarding clinical expertise, our team delivered 120 opinions per week (representing a total of 21 h), of which 29% were delivered to patients and 69% to medical practitioners. If these were delivered using TLM, it would represent a potential weekly income of EUR 500 (tele-expertise) and EUR 775 (teleconsultations). Regarding the research activity, 70% of investigators considered the frequency of visits to be a limiting factor for patient inclusions; nearly half of the patients surveyed would be in favour of having teleconsultations in place of (40%) or in addition to (56%) in-person visits. CONCLUSION Whereas TLM has become widely used as a back-up procedure to in-person consultations during the COVID-19 pandemic, the solutions it provides to the problems encountered in performing expertise and research activities have made it a new conventional follow-up modality for patients with rare diseases.
Collapse
Affiliation(s)
- Quentin Ducrocq
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
| | - Laurence Guédon-Moreau
- Université de Lille, Faculté de Médecine et CHU de Lille, Clinique de Cardiologie et Maladies Vasculaires, F-59000 Lille, France;
| | - David Launay
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Louis Terriou
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
| | - Sandrine Morell-Dubois
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Hélène Maillard
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Guillaume Lefèvre
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- CHU Lille, Laboratoire d’Immunologie, F-59000 Lille, France
| | - Vincent Sobanski
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Marc Lambert
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- CHU Lille, Département de Médecine Polyvalente Post-Urgences, F-59000 Lille, France
- Univ. Lille, U1167—RIDAGE—Risk Factors and Molecular Determinants of Aging-Related Diseases, F-59000 Lille, France
| | - Cécile Yelnik
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
- CHU Lille, Département de Médecine Polyvalente Post-Urgences, F-59000 Lille, France
- Univ. Lille, U1167—RIDAGE—Risk Factors and Molecular Determinants of Aging-Related Diseases, F-59000 Lille, France
| | - Meryem-Maud Farhat
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Maria José Garcia Fernandez
- Unité Matériaux et Transformations (UMET) UMR CNRS 8207, Université Lille 1, F-59655 Villeneuve d’Ascq, France;
- Inserm, CHU Lille, U1008—Controlled Drug Delivery System and Biomaterials, University Lille, F-59000 Lille, France
| | - Eric Hachulla
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| | - Sébastien Sanges
- CHU Lille, Service de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Auto-Immunes Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000 Lille, France; (Q.D.); (D.L.); (L.T.); (S.M.-D.); (H.M.); (V.S.); (M.L.); (C.Y.); (M.-M.F.); (E.H.)
- Univ. Lille, U1286—INFINITE—Institute for Translational Research in Inflammation, F-59000 Lille, France;
- Inserm, F-59000 Lille, France
- Health Care Provider of the European Reference Network on Rare Connective Tissue and Musculoskeletal Diseases Network (ReCONNET), F-59000 Lille, France
| |
Collapse
|
8
|
Pye S, Webster E, Zielinski R, Honeyball F. 'The best thing since sliced bread': Patient experiences of teleoncology in western NSW. Aust J Rural Health 2023; 31:90-97. [PMID: 36053275 DOI: 10.1111/ajr.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This study explored experiences of rural cancer patients who were receiving treatments by remote video-assisted chemotherapy (RVAC) or participating in clinical trials remotely. SETTING Participants lived in Coonabarabran or Dubbo in western NSW. PARTICIPANTS Seven cancer patients undergoing treatment for breast, bladder or colon cancer, renal cell carcinoma or lymphoma. DESIGN Appreciative inquiry informed this qualitative study. Semi-structured interviews were conducted between July 2018 and January 2019 and thematically analysed. RESULTS The patient experience of teleoncology was overwhelmingly positive. Patients explained the value of relationships that developed with the local and virtual care team. Patients felt they received better care if they saw the same oncologist for the duration of their treatment and felt RVAC had accommodated this. Teleoncology allowed patients to remain independent because they were able to maintain their usual support mechanisms including family, friends and health care team. Patients described the reduced physical and emotional travel burden in addition to reduction in travel time and cost. CONCLUSIONS These findings highlight the acceptability of teleoncology for rural patients as chemotherapy can be added to the health care and social and emotional supports, which exist in their hometown. Expansion of teleoncology should be codesigned with local communities with a focus on establishing care teams with consistent staffing to build trust between the treating team and the patient. These relationships improve the patient experience and enhance patient independence, which is a desirable attribute of cancer survivorship. Recruitment to clinical trials using teleoncology is acceptable and should be factored into trial development.
Collapse
Affiliation(s)
- Sid Pye
- School of Rural Health (currently Westmead Hospital), University of Sydney, Westmead, NSW, Australia
| | - Emma Webster
- School of Rural Health, University of Sydney, Dubbo, NSW, Australia
| | - Rob Zielinski
- Western NSW Local Health District, Western Sydney University, Orange, NSW, Australia
| | - Florian Honeyball
- Western NSW Local Health District, School of Rural Health, University of Sydney, Dubbo, NSW, Australia
| |
Collapse
|
9
|
Thomas EE, Kelly JT, Taylor ML, Mendis R, Banbury A, Haydon H, Catto J, Der Vartanian C, Smith AC, Caffery LJ. Telehealth adoption in cancer clinical trials: An Australian perspective. Asia Pac J Clin Oncol 2022. [DOI: 10.1111/ajco.13899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/08/2022] [Accepted: 10/22/2022] [Indexed: 12/13/2022]
Affiliation(s)
- Emma E. Thomas
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Jaimon T. Kelly
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Monica L. Taylor
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Roshni Mendis
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Annie Banbury
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | - Helen Haydon
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| | | | | | - Anthony C. Smith
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
- Centre for Innovative Medical Technology University of Southern Denmark Odense Denmark
| | - Liam J. Caffery
- Centre for Online Health The University of Queensland Brisbane Queensland Australia
- Centre for Health Services Research The University of Queensland Brisbane Queensland Australia
| |
Collapse
|
10
|
McPhee NJ, Nightingale CE, Harris SJ, Segelov E, Ristevski E. Barriers and enablers to cancer clinical trial participation and initiatives to improve opportunities for rural cancer patients: A scoping review. Clin Trials 2022; 19:464-476. [PMID: 35586873 DOI: 10.1177/17407745221090733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Claire E Nightingale
- Monash Rural Health, Monash University, Bendigo, VIC, Australia.,Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Samuel J Harris
- Department of Medical Oncology, Bendigo Health, Bendigo, VIC, Australia
| | - Eva Segelov
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Monash University, Clayton, VIC, Australia.,Department of Oncology, Monash Health, Clayton, VIC, Australia
| | - Eli Ristevski
- Monash Rural Health, Monash University, Warragul, VIC, Australia
| |
Collapse
|
11
|
Roberts NA, Cubitt A, Lindsay D, Bury K, Dixon J, Gebbie C, Hawkins CA, Major T, Jenkins-Marsh S, Morris-Smith B, Poxton M, Richmond S, Smith D, Stoneley A, Thaker DA, Wilson E, Woollett A, Underhill C, Sabesan S. Teletrials, the new norm? Expert recommendations for teletrials into the future: Findings from the Clinical Oncology Society of Australia Clinical Trial Research Professionals Group Workshop. Asia Pac J Clin Oncol 2022; 18:650-659. [PMID: 35098670 DOI: 10.1111/ajco.13737] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 11/01/2021] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The Australasian Teletrial Model was piloted in co-funded sites across Australia. The purpose was to extend the reach of clinical trials using telemedicine to improve equity and access to this treatment pathway for oncology patients. Experts across Australia gathered to share the learnings of implementation so that future directions can be effective and sustainable. METHODS The 1-day workshop was attended in person and virtually. Attendees were invited to analyze and disseminate the results. Recordings from the presentations were coded independently by three researchers and synthesized. The results were sent to the authorship team for further review to build consensus on the findings in three drafts. RESULTS Four key themes were identified: "Being on the Same Page," "Building Foundations," "Key Roles in Teletrials," and "Incentives." Although there were many successes that were accelerated by the COVID-19 pandemic, there is work still to be done. CONCLUSION The Australasian Teletrial Model has been identified as acceptable and feasible. Future directions need to continue to work on streamlining regulatory processes, implementation and monitoring, and build knowledge to further build networks across Australia.
Collapse
Affiliation(s)
- Natasha A Roberts
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,University of Queensland Clinical Centre for Research (UQCCR), Herston, Queensland, Australia.,Clinical Oncology Society of Australia Clinical Trials Research Professionals Group, Sydney, New South Wales, Australia
| | - Annette Cubitt
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Clinical Oncology Society of Australia Clinical Trials Research Professionals Group, Sydney, New South Wales, Australia
| | - Dianne Lindsay
- Clinical Oncology Society of Australia Clinical Trials Research Professionals Group, Sydney, New South Wales, Australia
| | - Kimberley Bury
- Townsville Cancer Centre, Townsville University Hospital, Townsville, Queensland, Australia
| | | | - Chantal Gebbie
- Clinical Oncology Society of Australia, Sydney, New South Wales, Australia
| | - Cheryl-Ann Hawkins
- Alfred Health, Melbourne, Victoria, Australia.,Melanoma and Skin Cancer Trials Ltd, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | | | | | - Melanie Poxton
- Townsville Cancer Centre, Townsville University Hospital, Townsville, Queensland, Australia
| | - Sue Richmond
- Clinical Research Unit, Cairns Hospital, Cairns, Queensland, Australia
| | - Delaine Smith
- Australasian Leukaemia and Lymphoma Group, Melbourne, Victoria, Australia
| | | | - Darshit A Thaker
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.,Clinical School, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
| | | | - Anne Woollett
- TrialHub, Alfred Health, Melbourne, Victoria, Australia
| | - Craig Underhill
- Border Medical Oncology, Albury-Wodonga Regional Cancer Centre, Albury, New South Wales, Australia.,Albury Campus, Regional Medical School, University of NSW, Albury, New South Wales, Australia
| | - Sabe Sabesan
- Townsville Cancer Centre, Townsville University Hospital, Townsville, Queensland, Australia
| |
Collapse
|
12
|
Patterson P, Allison KR, Bibby H, Thompson K, Lewin J, Briggs T, Walker R, Osborn M, Plaster M, Hayward A, Henney R, George S, Keuskamp D, Anazodo A. The Australian Youth Cancer Service: Developing and Monitoring the Activity of Nationally Coordinated Adolescent and Young Adult Cancer Care. Cancers (Basel) 2021; 13:cancers13112675. [PMID: 34071622 PMCID: PMC8198716 DOI: 10.3390/cancers13112675] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/21/2021] [Accepted: 05/26/2021] [Indexed: 12/14/2022] Open
Abstract
Adolescents and young adults (aged 15-25 years) diagnosed with cancer have unique medical and psychosocial experiences and care needs, distinct from those of paediatric and older adult patients. Since 2011, the Australian Youth Cancer Services have provided developmentally appropriate, multidisciplinary and comprehensive care to these young patients, facilitated by national service coordination and activity data collection and monitoring. This paper reports on how the Youth Cancer Services have conceptualised and delivered quality youth cancer care in four priority areas: clinical trial participation, oncofertility, psychosocial care and survivorship. National activity data collected by the Youth Cancer Services between 2016-17 and 2019-20 are used to illustrate how service monitoring processes have facilitated improvements in coordination and accountability across multiple indicators of quality youth cancer care, including clinical trial participation, access to fertility information and preservation, psychosocial screening and care and the transition from active treatment to survivorship. Accounts of both service delivery and monitoring and evaluation processes within the Australian Youth Cancer Services provide an exemplar of how coordinated initiatives may be employed to deliver, monitor and improve quality cancer care for adolescents and young adults.
Collapse
Affiliation(s)
- Pandora Patterson
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia; (K.R.A.); (H.B.); (D.K.)
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, Australia
- Correspondence:
| | - Kimberley R. Allison
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia; (K.R.A.); (H.B.); (D.K.)
| | - Helen Bibby
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia; (K.R.A.); (H.B.); (D.K.)
| | - Kate Thompson
- Victoria/Tasmania Youth Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia; (K.T.); (J.L.)
- ONTrac at PeterMac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Jeremy Lewin
- Victoria/Tasmania Youth Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia; (K.T.); (J.L.)
- ONTrac at PeterMac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Department of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Taia Briggs
- New South Wales/Australian Capital Territory Youth Cancer Service, Sydney, NSW 2031, Australia; (T.B.); (A.A.)
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Rick Walker
- Queensland Youth Cancer Service, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia; (R.W.); (R.H.)
- Oncology Services Group, Children’s Health Queensland, Brisbane, QLD 4000, Australia
- Princess Alexandra Hospital, Brisbane, QLD 4102, Australia
- School of Medicine, University of Queensland, Brisbane, QLD 4072, Australia
| | - Michael Osborn
- South Australia/Northern Territory Youth Cancer Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; (M.O.); (A.H.)
- Department of Haematology and Oncology, Women’s and Children’s Hospital, Adelaide, SA 5006, Australia
| | - Meg Plaster
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (M.P.); (S.G.)
- Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
| | - Allan Hayward
- South Australia/Northern Territory Youth Cancer Service, Royal Adelaide Hospital, Adelaide, SA 5000, Australia; (M.O.); (A.H.)
| | - Roslyn Henney
- Queensland Youth Cancer Service, Queensland Children’s Hospital, Brisbane, QLD 4101, Australia; (R.W.); (R.H.)
| | - Shannyn George
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia; (M.P.); (S.G.)
| | - Dominic Keuskamp
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia; (K.R.A.); (H.B.); (D.K.)
| | - Antoinette Anazodo
- New South Wales/Australian Capital Territory Youth Cancer Service, Sydney, NSW 2031, Australia; (T.B.); (A.A.)
- Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW 2031, Australia
- School of Women and Children’s Health, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Kids Cancer Centre, Sydney Children’s Hospital, Sydney, NSW 2031, Australia
| |
Collapse
|