1
|
Mali SB. Role of telemedicine in head neck cancer. Oral Oncol 2024; 151:106746. [PMID: 38460287 DOI: 10.1016/j.oraloncology.2024.106746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024]
Abstract
Chemo-radiotherapy and head and neck cancers are common adverse outcomes that impact patients' quality of life. The increasing cancer incidence and healthcare service shortages necessitate new strategies for optimal treatments and follow-ups. Digitalized healthcare, including digital health, telemedicine, and telemonitoring, is promising. HNC requires multidisciplinary team intervention, including speech language pathology telepractice models. Mobile health-based interventions can help cancer survivors increase physical activity and improve rehabilitation services. Effective self-management skills can improve outcomes. Advancements in communication technologies have led to telecommunication-based interventions incorporating swallowing exercises, education, monitoring, feedback, self-management, and communication. Home-based remote rehabilitation is urgent, especially during the COVID-19 pandemic, but the optimal strategy and effectiveness of remote interventions remain unclear. Telehealth interventions represent a possible novel approach to increase access to care across the cancer continuum, strengthen patients' knowledge and self-management, provide continuity of services, and enable remote monitoring of symptoms and response to treatment. Telehealth patients are typically younger, more likely to be English-speaking, and more likely to be female. These disparities widened slightly after the start of the pandemic but were also present prior to the pandemic.
Collapse
Affiliation(s)
- Shrikant B Mali
- Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hiray Dental College and Hospital Nashik, India.
| |
Collapse
|
2
|
Krouse RS, Zhang S, Wendel CS, Sun V, Grant M, Ercolano E, Hornbrook MC, Cidav Z, Nehemiah A, Rock M, Appel S, Hibbard JH, Holcomb MJ. A randomized prospective trial of an ostomy telehealth intervention for cancer survivors. Cancer 2024; 130:618-635. [PMID: 37905783 DOI: 10.1002/cncr.35091] [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: 03/07/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND Cancer survivors with ostomies face complex challenges. This study compared the Ostomy Self-Management Telehealth program (OSMT) versus attention control usual care (UC). METHODS Three academic centers randomized participants. OSMT group sessions were led by ostomy nurses and peer ostomates (three for ostomates-only, one for support persons, and one review session for both). Surveys at baseline, OSMT completion, and 6 months were primary outcome patient activation (PAM), self-efficacy (SE), City of Hope quality of life-Ostomy (COH-O), and Hospital Anxiety and Depression Scale (HADS). Surveys were scored per guidelines for those completing at least two surveys. Linear mixed effects models were used to select potential covariates for the final model and to test the impact of OSMT within each timeframe. RESULTS A total of 90 OSMT and 101 UC fulfilled analysis criteria. Arms were well-matched but types of tumors were unevenly distributed (p = .023). The OSMT arm had a nonsignificant improvement in PAM (confidence interval [CI], -3.65 to 5.3]; 4.0 vs. 2.9) at 6 months. There were no significant differences in other surveys. There was a significant OSMT benefit for urinary tumors (four SE domains). Higher OSMT session attendance was associated with post-session improvements in five SE domains (p < .05), two COH-O domains (p < .05), and HADS anxiety (p = .01). At 6 months, there remained improvements in one SE domain (p < .05), one COH-O domain (p < .05), and HADS anxiety (p < .01). CONCLUSIONS No clear benefit was seen for the OSMT intervention, although there may be an advantage based on type of tumor. Benefit with greater session attendance was also encouraging. PLAIN LANGUAGE SUMMARY Cancer patients with ostomies have many challenges. We tested a telehealth curriculum compared to usual care. There are indications of benefit for the program for those that attend more sessions and those with urostomies.
Collapse
Affiliation(s)
- Robert S Krouse
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Siqi Zhang
- Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Virginia Sun
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA
| | - Marcia Grant
- Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA
| | | | - Mark C Hornbrook
- Kaiser Permanente Center for Health Research, Portland, Oregon, USA
| | - Zuleyha Cidav
- Center for Mental Health, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ariel Nehemiah
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Matthew Rock
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Scott Appel
- Biostatistics Analysis Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Judith H Hibbard
- Department of Planning, Public Policy & Management, University of Oregon, Eugene, Oregon, USA
| | - Michael J Holcomb
- Arizona Telemedicine Program, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
3
|
Leske M, Galanis C, Koczwara B, Beatty L. A meta-analysis of healthy lifestyle interventions addressing quality of life of cancer survivors in the post treatment phase. J Cancer Surviv 2024:10.1007/s11764-023-01514-x. [PMID: 38206430 DOI: 10.1007/s11764-023-01514-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: 06/14/2023] [Accepted: 12/13/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE This study's primary aim was to investigate whether including a mental health component to healthy lifestyle interventions are associated with greater effects on quality of life (QoL) for post-treatment cancer survivors than addressing physical activity and/or nutrition alone. METHODS PsycINFO, Scopus, Medline, CINAHL, and Google Scholar were searched to identify randomised control trials of healthy lifestyle interventions for post-treatment cancer survivors, with a usual care or waitlist control, and measured QoL. Meta-analyses quantified the effects of interventions vs controls at post-treatment on total QoL, physical, emotional, and social well-being. Subgroup analyses compared interventions with vs without a mental health component, modes of delivery, and duration. The quality of the included studies was assessed using the Cochrane Risk of Bias 2. RESULTS Eighty-eight papers evaluating 110 interventions were included: 66 effect sizes were extracted for meta-analysis, and 22 papers were narratively synthesised. The pooled effect size demonstrated a small, significant effect of healthy lifestyle interventions in comparison to control for all QoL outcomes (total g = 0.32, p >.001; physical g = 0.19, p = 0.05; emotional g = 0.20, p >.001; social g = 0.18, p = 0.01). There was no significant difference between interventions with vs without a mental health component. Face-to-face delivered interventions were associated with greater total QoL and physical well-being compared to other modalities. Interventions delivered ≤12 weeks were associated with greater physical well-being than those delivered ≥13 weeks. Overall, studies had substantial levels of heterogeneity and 55.9% demonstrated high risk of bias. CONCLUSIONS Participating in a healthy lifestyle intervention following cancer treatment improves QoL. Few trials addressed mental health or evaluated online or telephone modalities; future research should develop and evaluate interventions that utilise these features. IMPLICATIONS FOR CANCER SURVIVORS Brief healthy lifestyle interventions can be recommended for cancer survivors, particularly those interested in improving physical well-being.
Collapse
Affiliation(s)
- Morgan Leske
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia.
| | - Christina Galanis
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Medical Oncology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Lisa Beatty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
4
|
Vagnini D, Natalucci V, Moi S, Vallorani L, Pietrelli A, Panico AR, Ferri Marini C, Lucertini F, Annibalini G, Sisti D, Rocchi MBL, Catalano V, Saita E, Emili R, Barbieri E. Home-based lifestyle intervention for breast cancer survivors: A surprising improvement in the quality of life during the first year of COVID-19 pandemic. PLoS One 2024; 19:e0296163. [PMID: 38165970 PMCID: PMC10760703 DOI: 10.1371/journal.pone.0296163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/28/2023] [Indexed: 01/04/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic induced an extraordinary impact on public mental health to a degree not completely understood, especially in vulnerable populations such as breast cancer (BC) survivors. In this study, we described the short- (after 3-month) and long- (after 12-month) term effects of a multidisciplinary home-based lifestyle intervention in Italian women BC survivors during the first year of COVID-19 pandemic. MATERIALS AND METHODS In total, 30 Italian BC survivors with risk factors for recurrence took part in the ongoing MoviS trial (protocol: NCT04818359). Between January 2020 and January 2021, a 3-month lifestyle intervention based on psychological counseling, nutrition, and exercise was carried out. Participants were asked to fill out psychological questionnaires for the assessment of quality of life (QoL) indicators (European Organization for Research and Treatment of Cancer QoL, EORTC-QLQ-C30) and psychological health measures such as fatigue (Brief Fatigue Inventory, BFI), distress (Distress Thermometer, DT and Psychological Distress Inventory, PDI), cancer-related fatigue (Verbal Rating Scale, VRS), and mood states (Profile of Mood States Questionnaire, POMS). IBM SPSS Statistical Software version 27.0 and R Project for Statistical Computing version 4.2.1 were used to process data. All participants were assessed at four time points: T0 (baseline), T1 (3-month), and follow-up at T2 and T3 (6- and 12-month, respectively) to measure primary (quality of life indicators) and secondary (psychological health) outcomes. Friedman non parametric test and Wilcoxon signed rank test (with Bonferroni correction) were conducted to investigate the statistically significant differences in psychometric scores and between assessment times. RESULTS Compared to baseline (T0), at T1 most of the QoL indicators (i.e., symptoms of fatigue and general health) were improved (p < 0.017) with the exception of a worsening in participants' social functioning ability. Also, perception of severity of fatigue, distress, cancer-related fatigue, depression, and anger enhanced. Compared to baseline (T0), at T3 we mainly observed a stable condition with T0-T1 pairwise comparison, however other secondary outcomes (i.e., fatigue mood state, confusion, and anxiety) significantly improved. DISCUSSION Our preliminary findings support the proposal of this lifestyle intervention for BC survivors. Despite the home-confinement due to the COVID-19 pandemic, the intervention surprisingly improved QoL indicators and psychological health of the participants.
Collapse
Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Valentina Natalucci
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Sara Moi
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Luciana Vallorani
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Alice Pietrelli
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Andrea Rocco Panico
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Carlo Ferri Marini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Francesco Lucertini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Giosuè Annibalini
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Davide Sisti
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Marco Bruno Luigi Rocchi
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| | - Vincenzo Catalano
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Rita Emili
- Medical Oncology Unit, AST Pesaro-Urbino, Santa Maria della Misericordia Hospital Urbino, Urbino, Italy
| | - Elena Barbieri
- Department of Biomolecular Sciences, Division of Exercise and Health Sciences, University of Urbino Carlo Bo, Urbino, Italy
| |
Collapse
|
5
|
Delestre F, Debailly R, Galiby LA, Hansel B. Determinants of motivation and adherence to a web application for health behaviour change: A qualitative study with cancer survivors. J Hum Nutr Diet 2023; 36:1701-1712. [PMID: 37272366 DOI: 10.1111/jhn.13185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/25/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND Given the increasing number of cancer survivors, eHealth may be an effective means to improve lifestyle-related behaviours. Limited data are available on the use of eHealth by post-cancer patients. The present study aimed to analyse the contexts of use to identify the determinants of cancer survivors' adherence and motivation to use a web application offering nutrition and physical activity coaching. METHODS Individual semi-structured interviews were conducted with cancer survivors who participated in an 8-week online program for health behaviour change. The interviews were analysed using thematic analysis. RESULTS Fifteen patients with a mean (SD) age of 62 (4.2) years completed the interview. Four themes relating to the environment and context of use were identified: digital use, social relations, health, and digital health interventions. Participants were familiar with digital tools through their professional work. Their motivation and adherence to the program improved through social relations; notably, a supportive family in addition to a trusted prescriber, continuity in the care pathway, and an appropriate choice of design features in the digital health intervention. With cancer survivorship, individuals no longer define themselves as sick but still need support to envisage the future more serenely. CONCLUSIONS Cancer survivorship plays a special role in people's adherence to online interventions for health behaviour change in addition to the influence of their social relations and health environment.
Collapse
Affiliation(s)
- Fabienne Delestre
- Université de Paris Cité, Paris, France
- Dietetics Department, APHP, Pitié Salpêtrière University Hospital, Paris, France
| | | | | | - Boris Hansel
- Université de Paris Cité, Paris, France
- Diabetology, Endocrinology and Nutrition Department, APHP, Bichat Hospital, Federation of Diabetology in Paris, Paris, France
| |
Collapse
|
6
|
Le Boutillier C, Jeyasingh-Jacob J, Jones L, King A, Archer S, Urch C. Improving personalised care and support planning for people living with treatable-but-not-curable cancer. BMJ Open Qual 2023; 12:e002322. [PMID: 37666580 PMCID: PMC10481844 DOI: 10.1136/bmjoq-2023-002322] [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: 02/18/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023] Open
Abstract
People living with treatable-but-not-curable (TbnC) cancer encounter cancer-related needs. While the NHS long-term plan commits to offering a Holistic Needs Assessment (HNA) and care plan to all people diagnosed with cancer, the content, delivery and timing of this intervention differs across practice. Understanding how people make sense of their cancer experience can support personalised care. A conceptual framework based on personal narratives of living with and beyond cancer (across different cancer types and all stages of the disease trajectory), identified three interlinked themes: Adversity, Restoration and Compatibility, resulting in the ARC framework.Our aim was to use the ARC framework to underpin the HNA to improve the experience of personalised care and support planning for people living with TbnC cancer. We used clinical work experience to operationalise the ARC framework and develop the intervention, called the ARC HNA, and service-level structure, called the ARC clinic. We sought expert input on the proposed content and structure from patients and clinicians through involvement and engagement activities. Delivered alongside standard care, the ARC HNA was piloted with patients on the TbnC cancer (myeloma and metastatic breast, prostate or lung) pathway, who were 6-24 months into their treatment. Iterations were made to the content, delivery and timing of the intervention based on user feedback.Fifty-one patients received the intervention. An average of 12 new concerns were identified per patient, and 96% of patients achieved at least one of their goals. Patients valued the space for reflection and follow-up, and clinicians valued the collaborative approach to meeting patients' supportive care needs. Compared with routine initial HNA and care plan completion rates of 13%, ARC clinic achieved 90% with all care plans shared with general practitioners. The ARC clinic adopts a novel and proactive approach to delivering HNAs and care plans in a meaningful and personalised way.
Collapse
Affiliation(s)
- Clair Le Boutillier
- Division of Methodologies, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, UK
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK
| | - Julian Jeyasingh-Jacob
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Lizzie Jones
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
- Maggie's West London, London, UK
| | - Alex King
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| | - Stephanie Archer
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Catherine Urch
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
- Department of Surgery, Cardiovascular and Cancer, Imperial College Healthcare NHS Trust, London, UK
| |
Collapse
|
7
|
Ruda-Santolaria L, Bergerot C, Hernandez J, Pena C, Montana MF, Galindo-Vazquez O, Torres-Blasco N, Castro-Figueroa E, Esenarro L, Sanchez-Ramirez JC, Estapé T, Gany F, Costas-Muniz R. Use of telehealth for psychosocial oncology: A mixed methods study about barriers to and opportunities with Latino patients from Latin America, Spain, and the United States. Psychooncology 2023; 32:1289-1297. [PMID: 37370195 DOI: 10.1002/pon.6182] [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: 11/25/2022] [Revised: 06/08/2023] [Accepted: 06/11/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES Telehealth for mental healthcare expanded rapidly with the COVID-19 pandemic's onset; however, global access disparities emerged. Telehealth challenges and opportunities for Latino cancer patients from different geographical regions must be explored. METHODS A cross-sectional online survey (March-July 2021) of mental health providers, serving Latino cancer patients in Latin America, United States, and Spain, contained close-ended questions related to the use of telehealth during the pandemic and open-ended questions on recommending/not recommending telehealth. RESULTS In a sample of 148 providers from 21 countries, 60.5% reported that at least some of their patients had difficulties with Internet speed and connectivity and lacked knowledge about using electronic devices (43.2%) or the Internet (45.4%). Lacking privacy at home (66.0%) and childcare (26.0%) were reported patient challenges. Internet connectivity or speed were issues for providers (43.2%) themselves. Improving patient reach was a reported telehealth benefit (64.2%). Geographical access (43.2%) and physical limitations (35.8%) were considerations in offering telehealth. Considerations for not recommending telehealth were patient age (24.3%) and lacking technological knowledge (29.1%). CONCLUSIONS Telehealth for mental healthcare may improve patient access issues caused by geographical and transportation conditions and patient functionality. Findings provide insight into telehealth benefits and challenges in Latino patient populations. Future studies should examine patient access and use by region.
Collapse
Affiliation(s)
| | - Cristiane Bergerot
- Centro de Cancer de Brasilia, Instituto Unity de Ensino e Pesquisa, Brasilia, DF, Brazil
| | | | - Cristina Pena
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | | | | | - Normarie Torres-Blasco
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Eida Castro-Figueroa
- Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
- School of Medicine and School of Behavioral and Brain Sciences, Ponce Research Institute, Ponce Health Sciences University, Ponce, Puerto Rico
| | - Loida Esenarro
- Instituto Nacional de Salud, Lima, Perú
- Universidad de Lima, Lima, Perú
| | | | | | - Francesca Gany
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - Rosario Costas-Muniz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| |
Collapse
|
8
|
Bettencourt N, Wilson CJ, Johnson PJ, D'Souza F. A Rebalancing of Financial Valuations and Expectations Moving Forward in the Telehealth Sector as the United States Moves Toward a Post-COVID-19 Reality. J Med Internet Res 2023; 25:e35857. [PMID: 37523216 PMCID: PMC10425816 DOI: 10.2196/35857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/29/2022] [Accepted: 06/16/2023] [Indexed: 08/01/2023] Open
Abstract
The telehealth sector of health care delivery experienced significant growth at the start of the pandemic as web-based care quickly became essential for the ongoing safety of patients and health care providers, such as clinicians and other health care professionals. After vaccines were introduced, however, telehealth companies lost value as the need for web-based care appeared to lessen. Presently, both existing telehealth companies and new entrants to the space are seeking ways to innovate, gain investor and customer buy-in, and overcome competitors. New companies are hoping to be seen not as pandemic-era substitutes, but instead as reinforcements to in-person care, valuable in their own right thanks to the convenience and technological advancements they bring. This struggle to reframe the value proposition, or perceived benefit, of telehealth is reflected in fluctuating stock prices and dropping valuations. This viewpoint summarizes the market volatility seen in the telehealth sector since the start of the COVID-19 pandemic and suggests potential opportunities for growth in the space. This is accomplished through a qualitative secondary research approach, leveraging contemporary sources, financial references such as Yahoo! Finance, and peer-reviewed literature to support predictions for the future market. We found that, in 2020, the size of the US telehealth market rose to US $17.9 billion and is estimated to reach US $140.7 billion by 2030. Additionally, digital health venture funding nearly doubled in 2020 over the prior 2 years with total funding rising to US $14.1 billion. However, these factors produced an oversaturated market in which the volume of supply was higher than demand, resulting in a sharp drop in valuations for some as vaccination rates climbed in 2021. In the face of this rebalancing, or return to normal following excessively high or unsustainable valuations, we suggest a possible path forward for telehealth companies in the postpandemic era. Suppliers' current role in the telehealth space-whether health care industry incumbents, that is, traditional health care delivery systems and companies, or "telehealth-first" challengers-are especially relevant to the specific growth strategies they should pursue. Furthermore, consideration of the areas of medicine and characteristics that best lend themselves to web-based care may lead to a greater chance for long-term success in a postpandemic health care delivery system. In the future, we believe investors should expect a bullish market, that is, one characterized by growing share prices. Success is likely to occur in part through changing the actual models of care, as opposed to moving traditional care to a web-based format. The oversaturated market will likely condense into select established telehealth giants who were able to adapt to the changing landscape. While investors may be reasonably hesitant regarding individual telehealth companies, the industry can expect slowed but continued growth.
Collapse
|
9
|
Vagnini D, Grassi MM, Saita E. Evaluating Somatic Experiencing ® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6412. [PMID: 37510644 PMCID: PMC10380079 DOI: 10.3390/ijerph20146412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Somatic Experiencing® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention.
Collapse
Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | | | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| |
Collapse
|
10
|
Kim YM, Min A, Hong HC. The Effectiveness of Telenursing Interventions on Patient Outcomes for Colorectal Cancer Patients: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151406. [PMID: 36966061 DOI: 10.1016/j.soncn.2023.151406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/23/2022] [Accepted: 02/22/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE To systematically review existing telenursing interventions for patients with colorectal cancer and determine the effects of such interventions on health-related quality of life and health care service utilization. DATA SOURCES We conducted a systematic review and meta-analysis after protocol registration. International databases, including PUBMED, EMBASE, CINAHL, Web of Science, SCOPUS, and CENTRAL and Korean databases, were searched. The last search was conducted on June 8, 2021. Two authors independently selected relevant studies, evaluated their methodological quality, and extracted data. A meta-analysis of randomized controlled trials was conducted using the statistical software STATA 16.0. Of the 223 articles retrieved, 7 were included for narrative synthesis and 3 were used for the meta-analysis. There were 857 patients in the telenursing group and 842 patients in the conventional group. Three studies applied theoretical frameworks for designing the intervention. CONCLUSION The effect of telenursing intervention was not different from that of usual care. However, both readmission rates and emergency department visits were lower in the telenursing group than in the usual care group, although these trends were not statistically significant. IMPLICATIONS FOR NURSING PRACTICE These findings indicate that telenursing intervention did not differ from usual care in terms of health-related quality of life while reducing readmission and emergency department visits in a nonstatistically significant manner. Therefore, telenursing interventions could serve as a partial alternative to current face-to-face interventions for patients with colorectal cancer.
Collapse
Affiliation(s)
- Young Man Kim
- Assistant Professor, College of Nursing·Research Institute of Nursing Science, Jeonbuk National University, Jeonju-si, South Korea
| | - Ari Min
- Associate Professor, Department of Nursing, Chung-Ang University, Seoul, South Korea
| | - Hye Chong Hong
- Associate Professor, Department of Nursing, Chung-Ang University, Seoul, South Korea.
| |
Collapse
|
11
|
Shaffer KM, Turner KL, Siwik C, Gonzalez BD, Upasani R, Glazer JV, Ferguson RJ, Joshua C, Low CA. Digital health and telehealth in cancer care: a scoping review of reviews. Lancet Digit Health 2023; 5:e316-e327. [PMID: 37100545 PMCID: PMC10124999 DOI: 10.1016/s2589-7500(23)00049-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/06/2023] [Accepted: 02/23/2023] [Indexed: 04/28/2023]
Abstract
The COVID-19 pandemic necessitated remote cancer care delivery via the internet and telephone, rapidly accelerating an already growing care delivery model and associated research. This scoping review of reviews characterised the peer-reviewed literature reviews on digital health and telehealth interventions in cancer published from database inception up to May 1, 2022, from PubMed, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, Cochrane Reviews, and Web of Science. Eligible reviews conducted a systematic literature search. Data were extracted in duplicate via a pre-defined online survey. Following screening, 134 reviews met the eligibility criteria. 77 of those reviews were published since 2020. 128 reviews summarised interventions intended for patients, 18 addressed family caregivers, and five addressed health-care providers. 56 reviews did not target a specific phase of the cancer continuum, whereas 48 reviews tended to address the active treatment phase. 29 reviews included a meta-analysis, with results showing positive effects on quality of life, psychological outcomes, and screening behaviours. 83 reviews did not report intervention implementation outcomes but when reported, 36 reported acceptability, 32 feasibility, and 29 fidelity outcomes. Several notable gaps were identified in these literature reviews on digital health and telehealth in cancer care. No reviews specifically addressed older adults, bereavement, or sustainability of interventions and only two reviews focused on comparing telehealth to in-person interventions. Addressing these gaps with rigorous systematic reviews might help guide continued innovation in remote cancer care, particularly for older adults and bereaved families, and integrate and sustain these interventions within oncology.
Collapse
Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA.
| | - Kea L Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Chelsea Siwik
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Rujula Upasani
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Jillian V Glazer
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Robert J Ferguson
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Catherine Joshua
- Center for Behavioral Health and Technology, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - Carissa A Low
- Division of Hematology/Oncology, University of Pittsburgh, Pittsburgh, PA, USA
| |
Collapse
|
12
|
Caminiti C, Annunziata MA, Di Giulio P, Isa L, Mosconi P, Nanni MG, Piredda M, Verusio C, Diodati F, Maglietta G, Passalacqua R. Psychosocial Impact of Virtual Cancer Care through Technology: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cancers (Basel) 2023; 15:cancers15072090. [PMID: 37046750 PMCID: PMC10093026 DOI: 10.3390/cancers15072090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
This meta-analysis of RCTs aimed to determine whether replacing face-to-face hospital care with telemedicine deteriorates psychosocial outcomes of adult cancer patients, in terms of quality of life (QoL), anxiety, distress, and depression. RCTs on interventions aimed at improving patient psychosocial outcomes were excluded. MEDLINE, EmBASE, and PsycInfo were searched on 13 May 2022 without language or date restrictions. In total, 1400 records were identified and 8 RCTs included (4434 subjects). Study methodological quality was moderate. Statistically significant improvements were observed in favor of the intervention for QoL (SMD = 0.22, 95% CI 0.01 to 0.43, p = 0.04), anxiety (SMD = −0.17, 95% CI −0.30 to −0.04, p < 0.01), and global distress (SMD = −0.38, 95% CI −0.51 to −0.25, p < 0.01). A meta-analysis on depression could not be performed. In subgroup analyses, the intervention appeared to be more beneficial for patients receiving active treatment vs. follow-up, for “other cancer types” vs. breast cancer, and for “other modes of administration” vs. telephone. Given the many potential advantages of being assisted at home, telemedicine appears to be a viable option in oncology. However, more research is necessary to determine the types of patients who may benefit the most from these alternative care modalities.
Collapse
Affiliation(s)
- Caterina Caminiti
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | | | - Paola Di Giulio
- Department of Public Health and Pediatrics, University of Turin, 10124 Torino, Italy
| | - Luciano Isa
- Division of Oncology, Hospital of Melegnano, 20064 Gorgonzola, Italy
| | - Paola Mosconi
- Laboratory for Medical Research and Consumer Involvement, Department of Public Health, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, 20156 Milan, Italy
| | - Maria Giulia Nanni
- Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, 44121 Ferrara, Italy
| | - Michela Piredda
- Research Unit of Nursing Sciences, Campus Bio-Medico University of Rome, 00128 Rome, Italy
| | - Claudio Verusio
- Department of Medical Oncology, Presidio Ospedaliero di Saronno, ASST Valle Olona, 21047 Saronno, Italy
| | - Francesca Diodati
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | - Giuseppe Maglietta
- Clinical and Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
| | - Rodolfo Passalacqua
- Medical Oncology Division, Department of Oncology, ASST of Cremona, 26100 Cremona, Italy
- Correspondence: ; Tel.: +39-0372-405237
| |
Collapse
|
13
|
Rostam Niakan Kalhori S, Rahmani Katigari M, Talebi Azadboni T, Pahlevanynejad S, Hosseini Eshpala R. The effect of m-health applications on self-care improvement in older adults: A systematic review. Inform Health Soc Care 2023. [PMID: 36867051 DOI: 10.1080/17538157.2023.2171878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
PARTICIPANTS Four electronic databases were searched on March 6, 2020 including Scopus, PubMed, ISI, and Embase. METHODS Our search consisted of concepts of "self-care," "elderly" and "Mobile device." English journal papers and, RCTs conducted for individuals older than 60 in the last 10 years were included. A narrative approach was used to synthesize the data due to the heterogeneous nature of the data. RESULTS Initially, 3047 studies were obtained and finally 19 studies were identified for deep analysis. 13 outcomes were identified in m-health interventions to help older adults' self-care. Each outcome has at least one or more positive results. The psychological status and clinical outcome measures were all significantly improved. CONCLUSION According to the findings, it is not possible to draw a definite positive decision about the effectiveness of interventions on older adults because the measures are very diverse and have been measured with different tools. However, it might be declared that m-health interventions have one or more positive results and can be used along with other interventions to improve the health of older adults.
Collapse
Affiliation(s)
- Sharareh Rostam Niakan Kalhori
- Peter L. Reichertz Institute for Medical Informatics, TU Braunschweig and Hannover Medical School, Braunschweig, Germany.,Ph.D of Medical Informatics, Health Information Technology Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Meysam Rahmani Katigari
- PhD in Health Information Management, Health Information Technology Department, Saveh University of Medical Sciences, Saveh, Iran.,Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
| | - Tahere Talebi Azadboni
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran.,Ph.D Candidate, Health Information Management Department, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrbanoo Pahlevanynejad
- Ph.D in Health Information Management, Health Information Technology Department, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran
| | - Rahil Hosseini Eshpala
- Ph.D Candidate, Health Information Management Department, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Joseph A, Shour AR, Lasebikan NN, Jimoh MA, Adegboyega BC, Nwachukwu E, Awofeso O, Ajose A, Ibraheem A, Fatiregun OA, Ali-Gombe M, Aliyu UM, Kotkat AE, Biyi-Olutunde OA, Oboh EO, Zubairu IH, Haider MR, Olatosi B, Puthoff D, Onitilo AA. Examining Cancer Patients' Perceptions of the Impact of COVID-19 on Teleoncology: Findings From 15 Nigerian Outpatient Cancer Clinics. JCO Glob Oncol 2023; 9:e2200221. [PMID: 36921242 PMCID: PMC10497253 DOI: 10.1200/go.22.00221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/25/2022] [Accepted: 12/16/2022] [Indexed: 03/17/2023] Open
Abstract
PURPOSE To examine cancer patients' perspectives on the impact of COVID-19 on teleoncology in Nigeria. METHODS Data from a multicenter survey conducted at 15 outpatient clinics to 1,097 patients with cancer from April and July 2020 were analyzed. The study outcome was telemedicine, defined as patients who reported their routine follow-up visits were converted to virtual visits because of COVID-19 (coded yes/no). Covariates included patient age, ethnicity, marital status, income, cancer treatment, service disruption, and cancer diagnosis/type. Stata/SE.v.17 (StataCorp, College Station, TX) was used to perform chi-square and logistic regression analyses. P values ≤ .05 were considered statistically significant. RESULTS The majority of the 1,097 patients with cancer were female (65.7%) and age 55 years and older (35.0%). Because of COVID-19, 12.6% of patients' routine follow-ups were converted to virtual visits. More patients who canceled/postponed surgery (17.7% v 7.5%; P ≤ .001), radiotherapy (16.9% v 5.3%; P ≤ .001), and chemotherapy (22.8% v 8.5%; P ≤ .001), injection chemotherapy (20.6% v 8.7%; P ≤ .001) and those who reported being seen less by their doctor/nurse (60.3% v 11.4%; P ≤ .001) reported more follow-up conversions to virtual visits. In multivariate analyses, patients seen less by their doctors/nurses were 14.3 times more likely to have their routine follow-ups converted to virtual visits than those who did not (odds ratio, 14.33; 95% CI, 8.36 to 24.58). CONCLUSION COVID-19 caused many patients with cancer in Nigeria to convert visits to a virtual format. These conversions were more common in patients whose surgery, radiotherapy, chemotherapy, and injection chemotherapy treatments were canceled or postponed. Our findings suggest how COVID-19 affects cancer treatment services and the importance of collecting teleoncological care data in Nigeria.
Collapse
Affiliation(s)
- Adedayo Joseph
- NSIA-LUTH Cancer Center, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Abdul R. Shour
- Cancer Care and Research Center, Marshfield Clinic Health System, Marshfield, WI
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| | | | - Mutiu A. Jimoh
- University College Hospital, Ibadan, Nigeria
- Lakeshore Cancer Center, Lagos, Nigeria
| | | | | | | | | | - Abiola Ibraheem
- Division of Hematology & Oncology, University of Illinois College of Medicine, Chicago, IL
| | | | | | - Usman M. Aliyu
- Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | | | | | | | | | | | - Bankole Olatosi
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| | - David Puthoff
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| | - Adedayo A. Onitilo
- Cancer Care and Research Center, Marshfield Clinic Health System, Marshfield, WI
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, WI
| |
Collapse
|
15
|
Burbury K, Brooks P, Gilham L, Solo I, Piper A, Underhill C, Campbell P, Blum R, Brown S, Barnett F, Torres J, Wang X, Poole W, Grobler A, Johnston G, Beer C, Cross H, Wong ZW. Telehealth in cancer care during the COVID-19 pandemic. J Telemed Telecare 2022:1357633X221136305. [PMID: 36484151 PMCID: PMC9742741 DOI: 10.1177/1357633x221136305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/14/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The Victorian COVID-19 Cancer Network (VCCN) Telehealth Expert Working Group aimed to evaluate the telehealth (TH) experience for cancer patients, carers and clinicians with the rapid uptake of TH in early 2020 during the COVID-19 pandemic. METHODS We conducted a prospective multi-centre cross-sectional survey involving eight Victorian regional and metropolitan cancer services and three consumer advocacy groups. Patients or their carers and clinicians who had TH consultations between 1 July 2020 and 31 December 2020 were invited to participate in patient and clinician surveys, respectively. These surveys were opened from September to December 2020. RESULTS The acceptability of TH via both video (82.9%) and phone (70.4%) were high though acceptability appeared to decrease in older phone TH users. Video was associated with higher satisfaction compared to phone (87.1% vs 79.7%) even though phone was more commonly used. Various themes from the qualitative surveys highlighted barriers and enablers to rapid TH implementation. DISCUSSION The high TH acceptability supports this as a safe and effective strategy for continued care and should persist beyond the pandemic environment, where patient preferences are considered and clinically appropriate. Ongoing support to health services for infrastructure and resources, as well as expansion of reimbursement eligibility criteria for patients and health professionals, including allied health and nursing, are crucial for sustainability.
Collapse
Affiliation(s)
- Kate Burbury
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Department of Haematology Peter MacCallum Cancer Centre, Melbourne Health, Victoria, Australia
| | - Peter Brooks
- Centre for Health Policy, University of Melbourne School of Population and Global Health, Parkville, Victoria, Australia
- Northern Health, Epping, Victoria, Australia
| | - Leslie Gilham
- Breast Cancer Network Australia, Camberwell, Victoria, Australia
| | - Ilana Solo
- Loddon Mallee Integrated Cancer Service, Bendigo Health
| | - Amanda Piper
- Strategy and Support Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Craig Underhill
- Border Medical Oncology, Research Unit, Albury, NSW, Australia
- Latrobe University, Wodonga, Victoria, Australia
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
- UNSW School of Clinical Medicine, Rural Clinical Campus, Albury, NSW, Australia
| | - Philip Campbell
- Barwon Health, Deakin University School of Medicine, Geelong, Victoria, Australia
| | - Robert Blum
- Bendigo Health Cancer Centre, Bendigo, Victoria, Australia
| | - Stephen Brown
- Ballarat Regional Integrated Cancer Centre, Ballarat, Victoria, Australia
| | - Frances Barnett
- Cancer Services, Northern Hospital, Epping, Victoria, Australia
| | - Javier Torres
- Goulburn Valley Health, Shepparton, West Hume Integrated Cancer Services, Melbourne University - Shepparton Clinical School, Victoria, Australia
| | - Xiaofang Wang
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | | | - Anneke Grobler
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Cassandra Beer
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
| | - Hannah Cross
- Victorian Comprehensive Cancer Centre Alliance, Parkville, Australia
| | - Zee Wan Wong
- Peninsula Health, Frankston, Victoria, Australia
- Monash University, Peninsula Clinical School, Frankston, Victoria, Australia
- Southern Melbourne Integrated Cancer Service, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Irurita-Morales P, Soto-Ruiz N, San Martín-Rodríguez L, Escalada-Hernández P, García-Vivar C. Use of Telehealth Among Cancer Survivors: A Scoping Review. Telemed J E Health 2022. [DOI: 10.1089/tmj.2022.0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Nelia Soto-Ruiz
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Leticia San Martín-Rodríguez
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Paula Escalada-Hernández
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre (UPNA), Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| |
Collapse
|
17
|
Bu S, Smith A‘B, Janssen A, Donnelly C, Dadich A, Mackenzie LJ, Smith AL, Young AL, Wu VS, Smith SJ, Sansom-Daly UM. Optimising implementation of telehealth in oncology: A systematic review examining barriers and enablers using the RE-AIM planning and evaluation framework. Crit Rev Oncol Hematol 2022; 180:103869. [DOI: 10.1016/j.critrevonc.2022.103869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/09/2022] Open
|
18
|
Uemoto Y, Yamanaka T, Kataoka Y, Wada Y, Aoyama Y, Kizawa R, Yamaguchi T, Kikawa Y, Mukai H, Taira N. Efficacy of Telemedicine Using Videoconferencing Systems in Outpatient Care for Patients With Cancer: A Systematic Review and Meta-Analysis. JCO Clin Cancer Inform 2022; 6:e2200084. [PMID: 36417685 DOI: 10.1200/cci.22.00084] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This systematic review aimed to investigate the efficacy of telemedicine (TM) using videoconferencing systems in outpatient care for patients with cancer. METHODS We searched six electronic databases (CENTRAL, MEDLINE, EMBASE, CINAHL, ICTRP, and ClinicalTrials.gov) through June 2021 to identify randomized controlled trials that evaluated the use of TM using videoconferencing systems compared with usual face-to-face care in outpatient care for patients with cancer. We assessed the certainty of evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation. RESULTS From the 2,400 articles screened, six randomized controlled trials were eligible for this study. Two studies evaluated the use of TM in cancer follow-up and four investigated psychotherapy for cancer. TM using videoconferencing systems may result in no differences in primary outcomes such as patient satisfaction (standardized mean difference, 0.11; 95% CI, -0.18 to 0.40) and outpatient attendance complete proportion (risk difference, 0.02%; 95% CI, -0.04 to 0.09), and secondary outcomes such as medical professional satisfaction, time devoted to outpatient care, and depression score. The certainty of evidence for these outcomes was low. Although the average money spent on outpatient visit was a primary outcome, the level of evidence was uncertain. CONCLUSION Our results suggest that TM using videoconferencing systems in outpatient care for patients with cancer may be as effective as usual face-to-face care. Use of TM more frequently may be considered for patients with cancer who are expected to obtain benefit from TM using videoconference systems.
Collapse
Affiliation(s)
- Yasuaki Uemoto
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Japan
| | - Taro Yamanaka
- Department of Medical Oncology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Sakyo-ku, Kyoto, Japan.,Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.,Section of Clinical Epidemiology, Department of Community Medicine, Kyoto University Graduate School of Medicine, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.,Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan
| | - Yoshitaka Wada
- Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.,Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Aichi, Japan
| | - Yosuke Aoyama
- Department of Medical Oncology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Rika Kizawa
- Department of Medical Oncology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Takeshi Yamaguchi
- Department of Medical Oncology, Toranomon Hospital, Minato-ku, Tokyo, Japan
| | - Yuichiro Kikawa
- Department of Breast Surgery, Kansai Medical University Hospital, Hirakata, Japan
| | - Hirofumi Mukai
- Division of Medical Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Naruto Taira
- Department of Breast and Thyroid Surgery, Kawasaki Medical School, Kurashiki, Okayama, Japan
| |
Collapse
|
19
|
Ni R, Liu M, Huang S, Yang J. Effects of eHealth Interventions on Quality of Life and Psychological Outcomes in Cardiac Surgery Patients: Systematic Review and Meta-analysis. J Med Internet Res 2022; 24:e40090. [PMID: 35972792 PMCID: PMC9428777 DOI: 10.2196/40090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/12/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients undergoing heart surgery may experience a range of physiological changes, and the postoperative recovery time is long. Patients and their families often have concerns about quality of life (QoL) after discharge. eHealth interventions may improve patient participation, ensure positive and effective health management, improve the quality of at-home care and the patient's quality of life, and reduce rates of depression. OBJECTIVE The purpose of this study was to evaluate the effects of eHealth interventions on the physiology, psychology, and compliance of adult patients after cardiac surgery to provide a theoretical basis for clinical practice. METHODS We conducted systematic searches of the following 4 electronic databases: PubMed, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials. Mean (SD) values were used to calculate the pooled effect sizes for all consecutive data, including QoL, anxiety, and depression. Where the same results were obtained using different instruments, we chose the standardized mean difference with a 95% CI to represent the combined effect size; otherwise, the mean difference (MD) with a 95% CI was used. Odds ratios were used to calculate the combined effect size for all dichotomous data. The Cohen Q test for chi-square distribution and an inconsistency index (I2) were used to test for heterogeneity among the studies. We chose a fixed-effects model to estimate the effect size if there was no significant heterogeneity in the data (I2≤50%); otherwise, a random-effects model was used. The quality of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trials (RoB 2). RESULTS The search identified 3632 papers, of which 19 met the inclusion criteria. In terms of physical outcomes, the score of the control group was lower than that of the intervention group (MD 0.15, 95% CI 0.03-0.27, I2=0%, P=.02). There was no significant difference in the mental outcomes between the intervention and control groups (MD 0.10, 95% CI -0.03 to 0.24, I2=46.4%, P=.14). The control group's score was lower than that of the intervention group for the depression outcomes (MD -0.53, 95% CI -0.89 to -0.17, I2=57.1%, P=.004). Compliance outcomes improved in most intervention groups. The results of the sensitivity analysis were robust. Nearly half of the included studies (9/19, 47%) had a moderate to high risk of bias. The quality of the evidence was medium to low. CONCLUSIONS eHealth improved the physical component of quality of life and depression after cardiac surgery; however, there was no statistical difference in the mental component of quality of life. The effectiveness of eHealth on patient compliance has been debated. Further high-quality studies on digital health are required. TRIAL REGISTRATION PROSPERO CRD42022327305; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327305.
Collapse
Affiliation(s)
- Ruping Ni
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Shunmin Huang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Jing Yang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| |
Collapse
|
20
|
Narcisse MR, Andersen JA, Felix HC, Hayes CJ, Eswaran H, McElfish PA. Factors associated with telehealth use among adults in the United States: Findings from the 2020 National Health Interview Survey. J Telemed Telecare 2022:1357633X221113192. [PMID: 35892167 DOI: 10.1177/1357633x221113192] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic, health care shifted to virtual interactions with health professionals. The aim of this study was to examine the determinants of telehealth use in a nationally representative sample of the United States adult population. METHODS The study used data from the 2020 National Health Interview Survey of 17,582 respondents aged ≥18. Andersen's model of health services utilization was employed to examine predisposing, enabling, and needs factors associated with past-year telehealth use. Multivariable logistic regression was conducted to examine statistical associations. RESULTS 32.5% of adults (n = 6402; mean age 51.6, SE = 0.4) reported telehealth use. Predisposing factors: Women and married/partnered adults and those with higher levels of education had greater odds of using telehealth. Adults living in Midwest and South and adults living in medium-small and non-metropolitan areas had decreased odds of using telehealth. Enabling factors: Income and having a usual source of care were positively associated with telehealth use. A negative association was found for those with no insurance and telehealth use, whereas a positive association was found for military insurance. Needs factors: Odds of using telehealth were increased for adults who had well-visits and ER visits in the past 12 months. Mental health services quadrupled the odds of telehealth use. Odds of using telehealth increased with each additional chronic disease, including COVID-19. CONCLUSION There are disparities in telehealth use according to sex, education, rurality, access to care, and health needs. Tackling these disparities is pivotal to ensure barriers to telehealth use are not exacerbated post-pandemic.
Collapse
Affiliation(s)
- Marie-Rachelle Narcisse
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Jennifer A Andersen
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Corey J Hayes
- College of Medicine, College of Pharmacy, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Hari Eswaran
- Institute of Digital Health and Innovation, 12215University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Pearl A McElfish
- College of Medicine, 37323University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| |
Collapse
|
21
|
Dennett AM, Harding KE, Peiris CL, Shields N, Barton C, Lynch L, Parente P, Lim D, Taylor NF. Efficacy of Group Exercise-Based Cancer Rehabilitation Delivered via Telehealth (TeleCaRe): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e38553. [PMID: 35849441 PMCID: PMC9345024 DOI: 10.2196/38553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
Background Access to rehabilitation to support cancer survivors to exercise is poor. Group exercise–based rehabilitation may be delivered remotely, but no trials have currently evaluated their efficacy. Objective We aimed to evaluate the efficacy of a group exercise–based cancer rehabilitation program delivered via telehealth compared to usual care for improving the quality of life of cancer survivors. Methods A parallel, assessor-blinded, pragmatic randomized controlled trial with embedded cost and qualitative analysis will be completed. In total, 116 cancer survivors will be recruited from a metropolitan health network in Melbourne, Victoria, Australia. The experimental group will attend an 8-week, twice-weekly, 60-minute exercise group session supervised via videoconferencing supplemented by a web-based home exercise program and information portal. The comparison group will receive usual care including standardized exercise advice and written information. Assessments will be completed at weeks 0 (baseline), 9 (post intervention), and 26 (follow-up). The primary outcome will be health-related quality of life measured using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at week 9. Secondary measures include walking capacity (6-minute walk test), physical activity (activPAL accelerometer), self-efficacy (Health Action Process Approach Questionnaire), and adverse events. Health service data including hospital length of stay, hospital readmissions, and emergency department presentations will be recorded. Semistructured interviews will be completed within an interpretive description framework to explore the patient experience. The primary outcome will be analyzed using linear mixed effects models. A cost-effectiveness analysis will also be performed. Results The trial commenced in April 2022. As of June 2022, we enrolled 14 participants. Conclusions This trial will inform the future implementation of cancer rehabilitation by providing important data about efficacy, safety, cost, and patient experience. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12621001417875; https://tinyurl.com/yc5crwtr International Registered Report Identifier (IRRID) PRR1-10.2196/38553
Collapse
Affiliation(s)
- Amy M Dennett
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Katherine E Harding
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Nora Shields
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Christian Barton
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Lauren Lynch
- Community Health, Eastern Health, Healesville, Australia
| | - Phillip Parente
- Department of Cancer Services, Eastern Health, Box Hill, Australia.,Eastern Health Clinical School, Monash University, Clayton, Australia
| | - David Lim
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
| | - Nicholas F Taylor
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| |
Collapse
|
22
|
Tun SM, Alluri S, Rastegar V, Visintainer P, Mertens W, Makari-Judson G. Mode of Detection of Second Events in Routine Surveillance of Early Stage Breast Cancer Patients. Clin Breast Cancer 2022; 22:e818-e824. [PMID: 35871906 DOI: 10.1016/j.clbc.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/15/2022] [Accepted: 06/24/2022] [Indexed: 12/22/2022]
Abstract
INTRODUCTION NCCN and ASCO guidelines recommend breast cancer (BC) follow-up to include clinical breast examination (CBE) every 6 months and annual mammography (AM) for 5 years. Given limited data to support CBE, we evaluated the modes of detection (MOD) of BC-events in a contemporary practice. METHODS We conducted a retrospective review of registry patients with early stage BC (DCIS, Stage I or II) diagnosed between 2010 and 2015 with at least 5 years of follow-up. Second events were defined as malignant (contralateral primary, ipsilateral breast tumor recurrence (IBTR), chest wall recurrence, regional node recurrence or distant relapse) or benign. MOD was categorized as patient complaint, clinical examination or breast imaging. RESULTS Sixty-three of 351 BC patients experienced second events. 15 had BC malignant events, including 4 distant disease, 5 contralateral primary, and 3 IBTR. 7/8 of IBTR and contralateral primary BC were AM detected. Patient complaints identified 4/4 distant relapses. Clinical exam identified 2/2 chest wall recurrences in post-mastectomy patients. CONCLUSIONS Only 2.8% (10/351) of early stage BC patients experienced recurrence during 5 years of follow-up. AM was the predominate MOD of both IBTR and new contralateral primary following breast conserving therapy. Patient complaints prompted evaluation for distant disease. Provider CBE was MOD in only 2/351, 0.6% 95% CI (2.1%-0.1%) of patients as chest wall recurrences postmastectomy. Given modern enhancements to imaging and lower recurrence rates, this data encourages the reassessment of guidelines for every 6-month CBE and provides basis to study telehealth in survivorship care.
Collapse
Affiliation(s)
- Soe Min Tun
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA
| | - Sunitha Alluri
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA; University of Massachusetts Medical School-Baystate, Springfield, MA
| | - Vida Rastegar
- Epidemiology and Biostatics, Baystate Medical Center, Springfield, MA
| | - Paul Visintainer
- University of Massachusetts Medical School-Baystate, Springfield, MA; Epidemiology and Biostatics, Baystate Medical Center, Springfield, MA
| | - Wilson Mertens
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA; University of Massachusetts Medical School-Baystate, Springfield, MA
| | - Grace Makari-Judson
- Division of Hematology-Oncology, Baystate Medical Center, Springfield, MA; University of Massachusetts Medical School-Baystate, Springfield, MA.
| |
Collapse
|
23
|
Burton M, Valet M, Caty G, Aboubakar F, Reychler G. Telerehabilitation physical exercise for patients with lung cancer through the course of their disease: A systematic review. J Telemed Telecare 2022:1357633X221094200. [PMID: 35546542 DOI: 10.1177/1357633x221094200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Evidence is shown for the benefits of physical activity, for patients with lung cancer, at different times through the course of the disease. Telerehabilitation can overcome some of barriers often met by patients to practice physical activity. The objective of this systematic review is to assess feasibility and safety of telerehabilitation for patients with lung cancer, its effects on physical capacity, quality of life, symptoms severity, depression and anxiety, survival, lung function, post-operative outcomes, dyspnoea and body composition. Secondary aim was to distinguish the telerehabilitation efficacy between the different phases of the disease. DATA SOURCE AND SELECTION CRITERIA Pubmed, PEDro, Scopus, ScienceDirect, randomized controlled trials and non-randomized controlled trials, written in French or English, of telerehabilitation among patients with lung cancer. RESULTS Eight studies were included. Telerehabilitation is safe but was characterized by a low recruitment and attendance rate (<70%). It enhances quality of life, muscle mass, depression and anxiety but it does not improve physical capacity (except in preoperative period), symptoms severity, survival, lung function or dyspnoea. After surgery, it ameliorates quality of life, depression and anxiety. During systemic treatments of lung cancer, it improves quality of life, symptoms severity and muscle mass. CONCLUSION Telerehabilitation could be proposed in patients with lung cancer as a complementary intervention of hospital-based programme to increase physical activity volume, compliance and self-efficacy. In case the classic programmes are not possible, it could also be an alternative approach for patients unable to participate to a hospital or community-based training programme.
Collapse
Affiliation(s)
- Madeleine Burton
- Secteur de kinésithérapie et ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
| | - Maxime Valet
- Service de Médecine physique et Réadaptation, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Université catholique de Louvain, Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Neuromusculoskeletal lab (NMSK), Brussels, Belgium
| | - Gilles Caty
- Service de Médecine Physique et Réadaptation, 82451Centre Hospitalier de Wallonie picarde, Tournai, Belgium
| | - Frank Aboubakar
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Département de médecine interne et de maladies infectieuses, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Gregory Reychler
- Secteur de kinésithérapie et ergothérapie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
- Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium
- Service de Pneumologie, 70492Cliniques universitaires Saint-Luc, Brussels, Belgium
| |
Collapse
|
24
|
Teicher S, Whitney RL, Liu R. Breast Cancer Survivors' Satisfaction and Information Recall of Telehealth Survivorship Care Plan Appointments During the COVID-19 Pandemic. Oncol Nurs Forum 2022; 49:223-231. [PMID: 35446836 DOI: 10.1188/22.onf.223-231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To examine patient satisfaction and information recall after telehealth breast cancer survivorship visits with a nurse practitioner. SAMPLE & SETTING Female survivors of breast cancer after their first visit with a nurse practitioner in the outpatient survivorship clinic post-treatment. METHODS & VARIABLES Participants included female survivors who were originally diagnosed with stage 0-III breast cancer and have since completed an initial telehealth appointment to review the survivorship care plan. Survivors were invited to complete a 20-question electronic survey about their satisfaction and recall of visit information. RESULTS 62 participants completed the survey and indicated an overall high level of satisfaction with telehealth survivorship appointments. Most recalled key survivorship information from the visit and felt the appropriate amount of information was discussed. Overall satisfaction was significantly correlated with the length and convenience of the appointment, and the personal manner and technical skills of the nurse practitioner. Survivors' age was not associated with significant differences in overall satisfaction. IMPLICATIONS FOR NURSING Telehealth for initial survivorship visits demonstrated high satisfaction with telehealth and the overall visit as a low-cost intervention to treat symptoms.
Collapse
|
25
|
Naik N, Hameed BMZ, Nayak SG, Gera A, Nandyal SR, Shetty DK, Shah M, Ibrahim S, Naik A, Kamath N, Mahdaviamiri D, D'costa KK, Rai BP, Chlosta P, Somani BK. Telemedicine and Telehealth in Urology-What Do the 'Patients' Think About It? Front Surg 2022; 9:863576. [PMID: 35495745 PMCID: PMC9051070 DOI: 10.3389/fsurg.2022.863576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/14/2022] [Indexed: 01/08/2023] Open
Abstract
Telemedicine is the delivery of healthcare to patients who are not in the same location as the physician. The practice of telemedicine has a large number of advantages, including cost savings, low chances of nosocomial infection, and fewer hospital visits. Teleclinics have been reported to be successful in the post-surgery and post-cancer therapy follow-up, and in offering consulting services for urolithiasis patients. This review focuses on identifying the outcomes of the recent studies related to the usage of video consulting in urology centers for hematuria referrals and follow-up appointments for a variety of illnesses, including benign prostatic hyperplasia (BPH), kidney stone disease (KSD), and urinary tract infections (UTIs) and found that they are highly acceptable and satisfied. Certain medical disorders can cause embarrassment, social exclusion, and also poor self-esteem, all of which can negatively impair health-related quality-of-life. Telemedicine has proven beneficial in such patients and is a reliable, cost-effective patient-care tool, and it has been successfully implemented in various healthcare settings and specialties.
Collapse
Affiliation(s)
- Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
| | - B. M. Zeeshan Hameed
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, Father Muller Medical College, Mangalore, India
| | - Sanjana Ganesh Nayak
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Anshita Gera
- Department of Computer Science and Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | | | - Dasharathraj K. Shetty
- Department of Humanities and Management, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Milap Shah
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Robotics and Urooncology, Max Hospital and Max Institute of Cancer Care, New Delhi, India
| | - Sufyan Ibrahim
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Aniket Naik
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Nagaraj Kamath
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Delaram Mahdaviamiri
- Manipal College of Pharmaceutical Sciences, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Kenisha Kevin D'costa
- Department of Biomedical Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, India
| | - Bhavan Prasad Rai
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University in Krakow, Kraków, Poland
| | - Bhaskar K. Somani
- iTRUE (International Training and Research in Uro-oncology and Endourology) Group, Manipal, India
- Department of Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom
| |
Collapse
|
26
|
He Y, Han X, Zou W, Liu X, Sun N, Zhou F. Telerehabilitation programmes for patients with cancer and survivors: a protocol for a systematic review. BMJ Open 2022; 12:e058981. [PMID: 35393328 PMCID: PMC8991069 DOI: 10.1136/bmjopen-2021-058981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The global cancer burden is a major public health problem. Cancer rehabilitation is an essential component of survivorship care for preventing complications, decreasing symptoms and improving functional quality of life (QOL). In addition to pre-existing challenges, the COVID-19 pandemic has greatly affected cancer rehabilitation programmes and their delivery to patients. This comprehensive systematic review will assess the efficacy and safety of telerehabilitation on functional outcomes and QOL in patients with cancer and survivors. METHODS AND ANALYSIS This study was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The following key electronic bibliographic databases will be searched from their inception to April 2021: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials and Physiotherapy Evidence Database (PEDro). We will include randomised controlled trials (RCTs) published in English that examine the effects of telerehabilitation programmes on patients with cancer and survivors. The terms 'telerehabilitation', 'neoplasm', 'RCT' and their analogous terms will be used in our search strategy. Two reviewers will independently complete the study screening, selection, data extraction and quality rating. The PEDro scale will be used to assess the methodological quality of the included studies. Narrative or quantitative synthesis will be conducted on the basis of the final data. The planned start and end dates for the study are 1 March 2021 and 1 May 2022, respectively. ETHICS AND DISSEMINATION Ethical approval will not be required for this review, and the results will be disseminated in peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42021243467.
Collapse
Affiliation(s)
- Yu He
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
| | - Xiaochai Han
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Wenchen Zou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xuemin Liu
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
| | - Nianyi Sun
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
- Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fenghua Zhou
- Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
- Department of Physical Medicine and Rehabilitation, The Second Clinical College, China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
27
|
Panteli M, Papantoniou A, Vaiouli P, Leonidou C, Panayiotou G. Feeling Down in Lockdown: Effects of COVID-19 pandemic on emotionally vulnerable individuals. COUNSELING PSYCHOLOGIST 2022. [DOI: 10.1177/00110000211064905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
We examined whether young adults with internalizing psychopathology during the pre-COVID-19 pandemic period exhibited different patterns of emotional responses than those without such psychopathology during the implementation of the “lockdown” in Cyprus, Greece. Two-wave longitudinal research was conducted i one hundred six college students completing measures of affective experiences, mental health, and quality of life during the prepandemic and lockdown periods. Increased negative affect and internalizing symptoms during the prepandemic period and decreased positive affect and increased perceived stress during the lockdown period both significantly predicted increased internalizing symptoms during the lockdown period. We discuss findings within the context of actions and interventions for young adults with existing internalizing symptomatology during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Maria Panteli
- University of Cyprus,
- Center for Applied Neuroscience,
| | | | | | | | | |
Collapse
|
28
|
Recommendations for the Development of Telemedicine in Poland Based on the Analysis of Barriers and Selected Telemedicine Solutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031221. [PMID: 35162248 PMCID: PMC8835106 DOI: 10.3390/ijerph19031221] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/12/2022] [Accepted: 01/18/2022] [Indexed: 02/04/2023]
Abstract
Technological development around the world has led to the digitalisation of the health system. Along with the digitalisation of the health sector, financial, legal, awareness-related, technological and IT barriers appeared. The aim of the article is to present recommendations for the development of telemedicine services in Poland on the basis of a list of implementation barriers and ways of resolving them in the USA and selected European countries. A literature review was conducted in accordance with the PRISMA-ScR, using the PubMed and Google Scholar databases, Scopus and the OECD iLibrary. A total of 59 literature positions were used, which constituted the references. The article presented the implemented and effective solutions in selected countries. Based on these solutions, recommendations for the development of telemedicine in Poland were presented, as well as successes in the form of telemedicine startups, which can inspire other countries. The analysis of the publications discussed in the article shows that the implementation of telemedicine services should begin with the elimination of barriers limiting the development of telemedicine systems. An important issue in their elimination is to analyse their interconnections and implement such solutions which would have a multi-area coverage.
Collapse
|
29
|
Haugstetter C, Mason R, Sanmugarajah J, Hattingh HL. Evaluation of a new emergency department avoidance model of care, the Cancer Urgent Assessment Clinic, in response to the COVID-19 pandemic. EMERGENCY CANCER CARE 2022; 1:11. [PMID: 36211536 PMCID: PMC9527716 DOI: 10.1186/s44201-022-00011-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022]
Abstract
Introduction The Cancer Urgent Assessment Clinic (CUAC) was an emergency department (ED) avoidance/unscheduled model of care implemented in response to the COVID-19 pandemic. The aim was to reduce the risk of COVID-19 exposure and infection by providing an alternative to ED for cancer patients while undergoing anticancer treatments. Methods The clinic incorporated a telephone triage process and face-to-face appointments 8am to 8pm, 7 days per week. CUAC operated between 23 March '20 and 31 July '20, led by a nurse practitioner candidate, oncology registrars, cancer nurse specialists, and overseen by oncology consultants. Evaluation followed a mixed-methods approach through (1) analysis of CUAC patient data, (2) comparison of ED cancer patient presentation data from a previous period (23 March 2019-31 July 2019), and (3) a patient survey. Results In total, 400 patients were telephone triaged via CUAC, with 166 recorded as having avoided ED. There was a reduction in the number of cancer patient admissions to the ED short stay unit during the clinic period compared with the same time-period in 2019: 130 vs. 234, associated with 615 fewer hours. Patient satisfaction was positive particularly regarding ease of access, time to treatment, confidence in assessment and treatment of cancer-related concerns, and likelihood of presenting to hospital when unwell during the pandemic. Discussion While initially being implemented to reduce the risk of COVID-19 exposure, this evaluation demonstrated the CUAC model was an efficient and potentially cost-saving model of care for the management of cancer patients with mild to moderate severity of disease and treatment-related concerns.
Collapse
Affiliation(s)
- Corrine Haugstetter
- grid.507967.aCancer, Blood and Respiratory Medicine, Gold Coast Health, Southport, QLD 4215 Australia
| | - Robert Mason
- grid.507967.aCancer, Blood and Respiratory Medicine, Gold Coast Health, Southport, QLD 4215 Australia
| | - Jasotha Sanmugarajah
- grid.507967.aCancer, Blood and Respiratory Medicine, Gold Coast Health, Southport, QLD 4215 Australia
| | - H. Laetitia Hattingh
- grid.507967.aMedical Services, Clinical Governance and Research, Gold Coast Health, Southport, QLD 4215 Australia ,grid.1022.10000 0004 0437 5432School of Pharmacy and Medical Sciences, Griffith University, Southport, QLD 4222 Australia
| |
Collapse
|
30
|
Dolan H, Eggett C, Holliday L, Delves S, Parkes D, Sutherland K. Virtual care in end of life and palliative care: A rapid evidence check. J Telemed Telecare 2021; 27:631-637. [PMID: 34726997 DOI: 10.1177/1357633x211046118] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this rapid evidence check was to identify virtual care modalities that are safe and effective in the delivery of end of life and palliative care. Thirty-three peer reviewed articles which were either review articles or interventional/evaluative studies presenting comparative data were identified through PubMed, Google, and Google Scholar searches. Extracted data was synthesized narratively and outcomes were categorised separately for patients, healthcare providers, caregivers and health system. Included studies reported on a wide range of virtual care modalities, including video consultation, mobile apps, videos, websites, telephone support, email and alert messages. Generally, studies reported similar or favourable quality of life outcomes to face-to-face palliative care, especially when virtual care was used as a supplement rather than a substitute for face-to-face care. Positive attitudes for perceived usefulness and helpfulness were reported by patients, caregivers and healthcare providers. Challenges identified related to technology limitations, trust, ethical concerns, administrative burden and evidence gaps. Overall, most studies found virtual care modalities to be safe and effective in end of life and palliative care with no detrimental adverse outcomes, when used as a supplement to face-to-face care.
Collapse
Affiliation(s)
- Hankiz Dolan
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Catherine Eggett
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Laura Holliday
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Shane Delves
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Donna Parkes
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| | - Kim Sutherland
- NSW 144952Agency for Clinical Innovation, Sydney, NSW, Australia
| |
Collapse
|
31
|
Spelten ER, Hardman RN, Pike KE, Yuen EYN, Wilson C. Best practice in the implementation of telehealth-based supportive cancer care: Using research evidence and discipline-based guidance. PATIENT EDUCATION AND COUNSELING 2021; 104:2682-2699. [PMID: 33926809 DOI: 10.1016/j.pec.2021.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/15/2021] [Accepted: 04/10/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To investigate what factors need consideration for telehealth services for cancer supportive care, given the rapid transition to telehealth as a result of COVID-19. METHODS A scoping review and a review of current guidance and guidelines provided by professional bodies, representing relevant discipline groups for cancer supportive care, were conducted. RESULTS We identified 19 papers and 23 telehealth guidance documents. The results highlight how the characteristics of patient group and healthcare provider influence the acceptability and utility of the service and establish a minimum set of preconditions. The reviews primarily examined patient-focused difficulties or issues with acceptability and efficacy, with only a minority highlighting how provider issues might also be implicated. By contrast, the guidance and guidelines described a need to address skills gaps in providing and receiving support through telehealth. CONCLUSION The capacity and willingness of services to adapt, in the context of COVID-19, is reassuring. It is important that the impact of the move to telehealth on service quality is assessed and systems put in place to ensure sustainability, acceptability, and adaptability. PRACTICE IMPLICATIONS Key recommendations can be made to assist service telehealth optimisation, many of which apply irrespective of the specific service focus.
Collapse
Affiliation(s)
| | - Ruth N Hardman
- La Trobe University, Rural Health School, Melbourne, Australia
| | - Kerryn E Pike
- La Trobe University, School of Psychology and Public Health, Melbourne, Australia
| | - Eva Y N Yuen
- La Trobe University, School of Psychology and Public Health, Melbourne, Australia; Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Australia
| | - Carlene Wilson
- La Trobe University, School of Psychology and Public Health, Melbourne, Australia; Olivia Newton-John Cancer Wellness and Research Centre, Austin Health, Melbourne, Australia
| |
Collapse
|
32
|
Arem H, Moses J, Cisneros C, Blondeau B, Nekhlyudov L, Killackey M, Pratt-Chapman ML. Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic. JCO Oncol Pract 2021; 18:e452-e461. [PMID: 34714706 DOI: 10.1200/op.21.00401] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE The COVID-19 pandemic led to rapid shifts in cancer survivorship care, including the widespread use of telehealth. Given the swift transition and limited data on preferences and experiences around telehealth, we surveyed oncology providers and post-treatment survivors to better understand experiences with the transition to telehealth. METHODS We distributed provider (MD, PA or NP, nurse, navigator, and social worker) and survivor surveys through the American College of Surgeons Commission on Cancer in mid-October 2020. Survivor surveys were also disseminated through patient advocacy organizations. We included questions on demographics, experiences with telehealth, and preferences for future telehealth utilization. RESULTS Among N = 607 providers and N = 539 cancer survivors, there was overwhelmingly more support from providers than from survivors for delivery of various types of survivorship care via telehealth and greater comfort with telehealth technologies. The only types of appointments deemed appropriate for survivorship care by both > 50% of providers and survivors were discussion of laboratory results or imaging, assessment and/or management of cancer treatment symptoms, nutrition counseling, and patient navigation support. Only a quarter of survivors reported increased access to health care services (25.5%), and 32.0% reported that they would use telehealth again. CONCLUSION Although there have been drastic changes in technological capabilities and billing reimbursement structures for telehealth, there are still concerns around delivery of a broad range of survivorship care services via telehealth, particularly from the patient perspective. Still, offering telehealth services, where endorsed by providers and if available and acceptable to cancer survivors, may provide more efficient and accessible care following the COVID-19 pandemic.
Collapse
Affiliation(s)
- Hannah Arem
- Medstar Health Research Institute, Healthcare Delivery Research, Washington, DC.,Department of Oncology, Georgetown University School of Medicine, Washington, DC
| | - Jenna Moses
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC
| | - Cindy Cisneros
- George Washington University Cancer Center, Community Advisory Board, Washington, DC
| | - Benoit Blondeau
- University of New Mexico, Albuquerque, NM.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Larissa Nekhlyudov
- Department of Epidemiology, George Washington University Milken Institute School of Public Health, Washington, DC.,George Washington University Cancer Center, Community Advisory Board, Washington, DC.,Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Maureen Killackey
- George Washington University Cancer Center, Community Advisory Board, Washington, DC.,American College of Surgeons' Commission on Cancer Site Reviewer, NYS Cancer Advisory Council, New York, NY
| | - Mandi L Pratt-Chapman
- George Washington University, School of Medicine and Health Sciences, Washington, DC
| |
Collapse
|
33
|
McGrowder DA, Miller FG, Vaz K, Anderson Cross M, Anderson-Jackson L, Bryan S, Latore L, Thompson R, Lowe D, McFarlane SR, Dilworth L. The Utilization and Benefits of Telehealth Services by Health Care Professionals Managing Breast Cancer Patients during the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:1401. [PMID: 34683081 PMCID: PMC8535379 DOI: 10.3390/healthcare9101401] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth is the delivery of many health care services and technologies to individuals at different geographical areas and is categorized as asynchronously or synchronously. The coronavirus disease 2019 (COVID-19) pandemic has caused major disruptions in health care delivery to breast cancer (BCa) patients and there is increasing demand for telehealth services. Globally, telehealth has become an essential means of communication between patient and health care provider. The application of telehealth to the treatment of BCa patients is evolving and increasingly research has demonstrated its feasibility and effectiveness in improving clinical, psychological and social outcomes. Two areas of telehealth that have significantly grown in the past decade and particularly since the beginning of the COVID-19 pandemic are telerehabilitation and teleoncology. These two technological systems provide opportunities at every stage of the cancer care continuum for BCa patients. We conducted a literature review that examined the use of telehealth services via its various modes of delivery among BCa patients particularly in areas of screening, diagnosis, treatment modalities, as well as satisfaction among patients and health care professionals. The advantages of telehealth models of service and delivery challenges to patients in remote areas are discussed.
Collapse
Affiliation(s)
- Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Fabian G. Miller
- Department of Physical Education, Faculty of Education, The Mico University College, 1A Marescaux Road, Kingston 5, Jamaica;
- Department of Biotechnology, Faculty of Science and Technology, The University of the West Indies, Kingston 7, Jamaica
| | - Kurt Vaz
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Melisa Anderson Cross
- School of Allied Health and Wellness, College of Health Sciences, University of Technology, Kingston 7, Jamaica;
| | - Lennox Anderson-Jackson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Sophia Bryan
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lyndon Latore
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Rory Thompson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Dwight Lowe
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| | - Shelly R. McFarlane
- Caribbean Institute for Health Research, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lowell Dilworth
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (K.V.); (L.A.-J.); (L.L.); (R.T.); (D.L.); (L.D.)
| |
Collapse
|
34
|
Chan RJ, Crichton M, Crawford-Williams F, Agbejule OA, Yu K, Hart NH, de Abreu Alves F, Ashbury FD, Eng L, Fitch M, Jain H, Jefford M, Klemanski D, Koczwara B, Loh K, Prasad M, Rugo H, Soto-Perez-de-Celis E, van den Hurk C, Chan A. The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews. Ann Oncol 2021; 32:1552-1570. [PMID: 34509615 DOI: 10.1016/j.annonc.2021.09.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews (SRs) was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators. METHODS PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. SRs that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021, were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research. RESULTS Twenty-nine SRs were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels. CONCLUSIONS This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.
Collapse
Affiliation(s)
- R J Chan
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia.
| | - M Crichton
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, Australia
| | - F Crawford-Williams
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - O A Agbejule
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - K Yu
- Department of Pharmacy, National University of Singapore, Singapore
| | - N H Hart
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, Australia
| | - F de Abreu Alves
- Department of Stomatology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | - F D Ashbury
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Oncology, University of Calgary, Calgary, Canada
| | - L Eng
- Division of Medical Oncology and Hematology, Department of Medicine, Princess Margaret Cancer Centre, Toronto, Canada; University Health Network, University of Toronto, Toronto, Canada
| | - M Fitch
- Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - H Jain
- Adult Hematolymphoid Division, Medical Oncology, Tata Memorial Centre, Affiliated to Homi Bhabha National Institute, Mumbai, India
| | - M Jefford
- Department of Health Services Research, Peter MacCallum Cancer Centre, Melbourne, Australia; Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Australia
| | - D Klemanski
- Cancer Support Service Line, The Ohio State University Comprehensive Cancer Center - James Cancer Hospital, Columbus, USA
| | - B Koczwara
- Flinders Medical Centre, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - K Loh
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore
| | - M Prasad
- Paediatric Oncology, Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | - H Rugo
- Division of Hematology and Oncology, University of California San Francisco, San Francisco, USA
| | - E Soto-Perez-de-Celis
- Department of Geriatrics. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - C van den Hurk
- Netherlands Comprehensive Cancer Organisation, Department of Research and Development, Utrecht, the Netherlands
| | - A Chan
- School of Pharmacy & Pharmaceutical Sciences, University of California Irvine, Irvine, USA
| | | |
Collapse
|
35
|
Feasibility, acceptability, and efficacy of online supportive care for individuals living with and beyond lung cancer: a systematic review. Support Care Cancer 2021; 29:6995-7011. [PMID: 34008080 PMCID: PMC8130779 DOI: 10.1007/s00520-021-06274-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/04/2021] [Indexed: 12/01/2022]
Abstract
Purpose To examine the evidence of the feasibility, acceptability, and potential efficacy of online supportive care interventions for people living with and beyond lung cancer (LWBLC). Methods Studies were identified through searches of Medline, EMBASE, PsychINFO, and CINAHL databases using a structured search strategy. The inclusion criteria (1) examined the feasibility, acceptability, and/or efficacy of an online intervention aiming to provide supportive care for people living with and beyond lung cancer; (2) delivered an intervention in a single arm or RCT study pre/post design; (3) if a mixed sample, presented independent lung cancer data. Results Eight studies were included; two randomised controlled trials (RCTs). Included studies reported on the following outcomes: feasibility and acceptability of an online, supportive care intervention, and/or changes in quality of life, emotional functioning, physical functioning, and/or symptom distress. Conclusion Preliminary evidence suggests that online supportive care among individuals LWBLC is feasible and acceptable, although there is little high-level evidence. Most were small pilot and feasibility studies, suggesting that online supportive care in this group is in its infancy. The integration of online supportive care into the cancer pathway may improve quality of life, physical and emotional functioning, and reduce symptom distress. Online modalities of supportive care can increase reach and accessibility of supportive care platforms, which could provide tailored support. People LWBLC display high symptom burden and unmet supportive care needs. More research is needed to address the dearth of literature in online supportive care for people LWBLC. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06274-x.
Collapse
|
36
|
Li J, Liu Y, Jiang J, Peng X, Hu X. Effect of telehealth interventions on quality of life in cancer survivors: A systematic review and meta-analysis of randomized controlled trials. Int J Nurs Stud 2021; 122:103970. [PMID: 34303269 DOI: 10.1016/j.ijnurstu.2021.103970] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND With advances in cancer disease diagnosis and treatment, the trends of cancer survival continue to increase, but cancer survivors usually experience disease- or treatment-related problems (including both physiological and psychological problems) and poorer quality of life. Various types of telehealth interventions have been widespread in the field of medical care and have been shown to be cost-effective, to have high levels of patient satisfaction, and to have high acceptability among health professionals. Currently, there is no definite conclusion about the effectiveness of telehealth interventions on cancer survivors' quality of life. OBJECTIVES To evaluate the effects of telehealth interventions on cancer survivors' quality of life and compare the effectiveness of different types. DESIGN A systematic review and meta-analysis. METHODS A systematic literature search was conducted in six databases (MEDLINE, Embase, the Cochrane Central Register of Controlled trials, CINAHL, PsycINFO, and Web of Science) to identify relevant studies from inception to 14 April 2021. Two reviewers independently screened studies and extracted the data. The Cochrane risk-of-bias tool was used to evaluate the quality of the included studies. Data synthesis was conducted in Review Manager (Version 5.3), and the quality of life scores were calculated by using the standard mean difference (SMD) and 95% confidence intervals (CIs). Sensitivity analysis and subgroup analysis were also conducted. RESULTS Twenty-eight randomized controlled trials (RCTs) published from 2002 to 2020 were included. Meta-analysis revealed significant effects of telehealth interventions on cancer survivors' quality of life (SMD = 0.24, 95% CI: 0.14-0.34, P < 0.00001). Subgroup analysis showed that the most effective method was application-based intervention (SMD = 0.41, 95% CI: 0.17-0.66) and the short-term telehealth intervention was more effective than other durations of intervention (SMD = 0.28, 95% CI: 0.06-0.50). The effects on breast cancer survivors' quality of life were greater than those on the other types of cancer survivors (SMD = 0.30, 95% CI: 0.10-0.51). Sensitivity analysis indicated that the pooled results were robust and reliable. CONCLUSION Telehealth interventions are effective and alternative methods for improving quality of life among cancer survivors. The most effective approach was application-based intervention, the most common approach was website-based intervention, and in terms of intervention durations, the short-term telehealth intervention was the most effective. Most telehealth interventions included breast cancer survivors. More large, well-designed RCTs are needed to confirm the effects of telehealth interventions on quality of life in cancer survivors.
Collapse
Affiliation(s)
- Juejin Li
- West China School of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou District, Chengdu, Sichuan, PR China
| | - Yong Liu
- Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jianjun Jiang
- Department of Palliative Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xingchen Peng
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Xiaolin Hu
- West China School of Nursing, West China Hospital, Sichuan University, No 37 Guo-xue-xiang Lane, Wuhou District, Chengdu, Sichuan, PR China.
| |
Collapse
|
37
|
Gordon LG, Ownsworth T, Bradford NK, Pinkham MB, Chan RJ. Electronic finance-related outcome measures (eFROMs): a new approach to screen for cancer-related financial toxicity in clinical practice. Support Care Cancer 2021; 29:5549-5551. [PMID: 33822242 DOI: 10.1007/s00520-021-06191-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Louisa G Gordon
- Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Brisbane, Q4006, Australia. .,School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology (QUT), Kelvin Grove, Brisbane, Q4059, Australia. .,Faculty of Medicine, The University of Queensland, Herston, Brisbane, Q4006, Australia.
| | - Tamara Ownsworth
- School of Applied Psychology and Menzies Health Institute of Queensland, Griffith University, Mt Gravatt, Brisbane, Q4122, Australia
| | - Natalie K Bradford
- Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Brisbane, Q4102, Australia
| | - Mark B Pinkham
- Faculty of Medicine, The University of Queensland, Herston, Brisbane, Q4006, Australia.,Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Brisbane, Q4102, Australia
| | - Raymond J Chan
- School of Nursing and Cancer and Palliative Care Outcomes Centre, Queensland University of Technology (QUT), Kelvin Grove, Brisbane, Q4059, Australia.,Division of Cancer Services, Princess Alexandra Hospital, Woolloongabba, Brisbane, Q4102, Australia
| |
Collapse
|
38
|
Price J, Brunet J. Feasibility and acceptability of a telehealth behavior change intervention for promoting physical activity and fruit and vegetable consumption among rural-living young adult cancer survivors. J Psychosoc Oncol 2021; 39:715-733. [PMID: 33798033 DOI: 10.1080/07347332.2021.1896616] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: We assessed the feasibility and acceptability of a 12-week telehealth behavior change intervention to promote physical activity and fruit and vegetable consumption among rural-living young adult cancer survivors.Methods: Participants met with a health coach once a week for 60 minutes for 12 weeks. Feasibility measures included rates of recruitment, enrollment, attrition, retention, adherence, and missing data. Acceptability was assessed using semi-structured interviews.Findings: Over 1-year, 18 individuals self-referred, 9 were eligible and consented to participate, and 2 dropped out. Retention was 74% and adherence was 95%. Participants considered the length of the intervention, synchronous communication with the health coach, and the distance-based delivery mode to be acceptable. Moreover, participants described key behavior change techniques and recommended minor changes.Implications: Findings provide information that can help refine future trials seeking to increase access to behavior change interventions and optimize participation in health-promoting behaviors for underserved populations.Trial registration: ClinicalTrials.gov. NCT03691545. Registered on October 1, 2018.
Collapse
Affiliation(s)
- Jenson Price
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Jennifer Brunet
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| |
Collapse
|
39
|
Barsom EZ, van Dalen ASHM, Blussé van Oud-Alblas M, Buskens CJ, van de Ven AWH, Tanis PJ, Schijven MP, Bemelman WA. Comparing video consultation and telephone consultation at the outpatient clinic of a tertiary referral centre: patient and provider benefits. ACTA ACUST UNITED AC 2020. [DOI: 10.1136/bmjinnov-2020-000512] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ObjectivesTelephone consultations are frequently used in the outpatient setting in order to avoid unnecessary travel and to reduce hospital visit-related costs for patients. However, they are limited by the absence of non-verbal communication in contrast to video consultation. Little is known considering the possible advantages of using video consultation in comparison to telephone consultation according to both patients and healthcare providers.MethodsPatients with colorectal diseases were asked to choose between a telephone consultation or a video consultation for their next appointment at the outpatient clinic of a tertiary referral centre. Willingness to use video consultation, value of non-verbal communication, patient satisfaction, provider satisfaction and user friendliness of the video connection technology were measured using questionnaires.ResultsNone of the included patients ever had a video consultation before with a healthcare provider. Nonetheless, 22/50 preferred a video consultation over a telephone consultation. Patients who preferred a video consultation underlined the benefits of providing visual feedback to both patients and healthcare providers. Moreover, healthcare providers felt they were better able to assess the patients’ healthcare condition.ConclusionFor patients who value both verbal and non-verbal interaction and feel comfortable with the use of video consultation, video consultation is the preferred contact modality. Shared decision making should be used to choose the preferred interaction modality. For patients with low digital skills, support might be needed or video consultation may not be the preferred choice.
Collapse
|
40
|
Paterson C, Gobel B, Gosselin T, Haylock PJ, Papadopoulou C, Slusser K, Rodriguez A, Pituskin E. Oncology Nursing During a Pandemic: Critical Reflections in the Context of COVID-19. Semin Oncol Nurs 2020; 36:151028. [PMID: 32423833 PMCID: PMC7177078 DOI: 10.1016/j.soncn.2020.151028] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To provide a critical reflection of COVID-19 in the context of oncology nursing and provide recommendations for caring for people affected by cancer during this pandemic. DATA SOURCES Electronic databases, including CINAHL, MEDLINE, PsychINFO, Scopus, professional web sites, and grey literature were searched using Google Scholar. CONCLUSION Nurses are key stakeholders in developing and implementing policies regarding standards of care during the COVID-19 pandemic. This pandemic poses several challenges for oncology services. Oncology nurses are providing a pivotal role in the care and management of the novel COVID-19 in the year landmarked as the International Year of the Nurse. IMPLICATIONS FOR NURSING PRACTICE It is too early to tell what shape this pandemic will take and its impact on oncology care. However, several important clinical considerations have been discussed to inform oncology nursing care and practice.
Collapse
Affiliation(s)
- Catherine Paterson
- University of Canberra, ACT, Australia; Canberra Health Services, ACT, Australia.
| | | | | | | | - Constantina Papadopoulou
- University of the West of Scotland School of Health Nursing and Midwifery, Hamilton, South Lanarkshire, UK
| | - Kim Slusser
- Smilow Cancer Hospital, Yale New Haven Hospital, New Haven, CT, USA
| | - Anna Rodriguez
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | | |
Collapse
|
41
|
Doyle-Lindrud S. State of eHealth in Cancer Care: Review of the Benefits and Limitations of eHealth Tools. Clin J Oncol Nurs 2020; 24:10-15. [PMID: 32441698 DOI: 10.1188/20.cjon.s1.10-15] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND eHealth has the potential to improve patient access to care through the use of various tools. OBJECTIVES This article provides a review of some eHealth technologies, including a discussion of their benefits and limitations. An overview of studies using eHealth technologies are summarized, and future directions are explored. METHODS A review of the eHealth literature was conducted, with a focus on outcomes of telehealth interventions in cancer care. FINDINGS eHealth can transform health care by expanding the reach of clinical cancer care. Examples of this expansion of care include patients who live in remote areas with limited access to oncology providers, patients who find travel challenging, and patients who prefer the convenience of communicating with their provider from their home. Such telehealth interventions can increase patient satisfaction, but additional research is needed to further evaluate patient outcomes.
Collapse
|