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Hansen M, Schiele K, Schear RM, Richardson RN, Munoz RJ, Bourne G, Eckhardt SG, Kvale E. A comparative cohort study of gastrointestinal oncology patients: Impact of a shift to telehealth on delivery of interprofessional cancer care. J Telemed Telecare 2024; 30:1116-1122. [PMID: 36071633 DOI: 10.1177/1357633x221122125] [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] [Indexed: 11/17/2022]
Abstract
Early studies of oncology visits performed via telehealth demonstrate patient and provider satisfaction; however, understanding of the impact of telehealth on clinic workflows is limited. The incorporation of telehealth visits into an interprofessional model of oncology care was evaluated to assess for changes in care delivery and patient engagement. New patients with a gastrointestinal cancer diagnosis who were actively undergoing treatment and followed for at least three months were divided into two cohorts based on telehealth utilization. Individual patient charts were reviewed by touchpoint, consisting of in-person visits, telehealth visits, phone calls, and patient portal messages. A total of 28 patient charts were analyzed, 11 pre-telehealth conventional care patients, and 17 telehealth patients. Telehealth cohort patients demonstrated an increased average number of total touchpoints when compared to the pre-telehealth cohort (p-value = 0.008) and had an increased number of patient portal and phone call touchpoints (p-value = 0.00 and 0.002). Telehealth provided more interactions between patients and providers demonstrating increased connectivity between a patient and their care team throughout their complex cancer journey. Clinic workflows may need to adjust to account for the increased demand of unscheduled patient interactions.
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Affiliation(s)
- Madison Hansen
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Kristan Schiele
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Rebekkah M Schear
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Robin N Richardson
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Rebecca J Munoz
- Robbins College of Health and Human Sciences, Baylor University, Houston, TX, USA
| | - Garrett Bourne
- Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - S Gail Eckhardt
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Elizabeth Kvale
- Livestrong Cancer Institutes, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
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Liljestrand C, Zingmark M. Use of information and communication technology in occupational therapy for older adults. Scand J Occup Ther 2024; 31:2271035. [PMID: 37878825 DOI: 10.1080/11038128.2023.2271035] [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: 01/04/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Information and communication technology (ICT) provides one solution to meet increasing demands for occupational therapy for older adults. AIMS/OBJECTIVES To examine if and how municipality-based occupational therapists (OTs) include ICT in their work, and which factors are associated with use of occupational therapy at a distance. MATERIAL AND METHODS Survey study including 167 OTs. Data were presented descriptively. Associations were analysed by Chi2 test and logistic regression models. RESULTS Forty-eight percent of OTs used ICT once a month or more. OTs belief on possibilites to use ICT is associated with replacement of physical home visits. Managers expectations and support also seem to be important factors. CONCLUSION ICT solutions are frequently used by OTs in home health care and can be considered complementing rather than replacing physical home visits. More knowledge is needed on when and how ICT solutions can be used by OTs and how factors that impact the use of ICT can be managed.
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Affiliation(s)
| | - Magnus Zingmark
- Health and Social Care Administration, Municipality of Östersund, Sweden
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Bilmiç E, Selçukbiricik F, Bagcivan G. The effectiveness of online pain management education on the patient related barriers to cancer pain management: A randomized controlled trial. Eur J Oncol Nurs 2023; 67:102422. [PMID: 37812994 DOI: 10.1016/j.ejon.2023.102422] [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: 01/29/2023] [Revised: 09/13/2023] [Accepted: 09/16/2023] [Indexed: 10/11/2023]
Abstract
PURPOSE This study aimed to evaluate the effectiveness of an online individualized education program on patient-related barriers to cancer pain management. METHODS In this parallel randomized controlled trial, 110 participants were assigned to the intervention or control group. Online individualized education was conducted as the intervention. Depending on participants' preferences, online education sessions were completed via Microsoft Teams, Zoom, or WhatsApp. The primary outcome is patient-related barriers to cancer pain management, and the secondary outcome is pain intensity. The Patient Information Form, the Edmonton Symptom Assessment Scale (ESAS), the Brief Pain Inventory (BPI), and the Barriers Questionnaire II (BQ-II) were used for data collection. The statistical effects of the intervention on the outcomes were modeled in repeated measures ANOVA test. RESULTS The results show that both the group (F = 11.316, p = 0.001) and time effects (F = 63.878, p < 0.001) individually have significant effects on the BQII total score. Also, there is a significant difference between groups regarding BQII total score regardless of time. The interaction between group and time is also significant (F = 127.764, p < 0.001) and substantially affects the BQII total score. Regarding pain intensity, the results show that the interaction between group and time is statistically significant for all pain categories (p < 0.05). In contrast, the group effect is not statistically significant for all pain categories (p > 0.05). Time effects are statistically significant for the "least" and "average" pain only (p < 0.05). CONCLUSION The result of this study presents evidence that individualized online education of cancer patients positively impacts reducing patient-related barriers to pain management and pain intensity.
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Affiliation(s)
- Ezgi Bilmiç
- Department of Medical Oncology, Bakirkoy Dr. Sadi Konuk Training & Research Hospital Istanbul, Turkiye
| | - Fatih Selçukbiricik
- Medical School and Department of Medical Oncology, Koç University, Istanbul, Turkiye
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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.
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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
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The telehealth program of occupational therapy among older people: an up-to-date scoping review. Aging Clin Exp Res 2023; 35:23-40. [PMID: 36344805 PMCID: PMC9640899 DOI: 10.1007/s40520-022-02291-w] [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: 06/14/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND The average life expectancy of older people is increasing, and most seniors desire to age at home and are capable of living independently. Occupational therapy (OT) is client-centered and uses patients' meaningful activities, or occupations, as treatment methods, thus playing an important role in later adulthood. Telemedicine removes the constraints of time and space, and the combination of OT and telemedicine can greatly improve medical efficiency and clinical effectiveness. AIMS The purpose of this scoping review was to examine the scope and effectiveness of telehealth OT for older people. METHODS This scoping review was conducted following the methodological framework proposed by Arksey and O'Malley. We searched the literature in five databases following the PICOS (Population, Intervention, Comparison, Outcome, Study design) guideline, from inception to April 2022. Two trained reviewers independently retrieved, screened, and extracted data, and used a descriptive synthesizing approach to summarize the results. RESULTS The initial search yielded 1249 studies from databases and manual searches, of which 20 were eligible and were included in the final review. A thematic analysis revealed five main themes related to telehealth OT: occupational assessment, occupational intervention, rehabilitation counseling, caregiver support, and activity monitoring. CONCLUSIONS Telehealth OT has been used widely for older people, focusing primarily on occupational assessment and intervention provided conveniently for occupational therapists and older clients. In addition, telehealth OT can monitor patients' activities and provide rehabilitation counseling and health education for the elderly and their caregivers, thus improving the security of their home life and the efficacy of OT. During the COVID-19 pandemic, telehealth will be an effective alternative to face-to-face modalities.
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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
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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.
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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
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Abbott-Gaffney CR, Gafni-Lachter L, Cason J, Sheaffer K, Harasink R, Donehower K, Jacobs K. Toward successful future use of telehealth in occupational therapy practice: What the COVID-19 rapid shift revealed. Work 2022; 71:385-394. [DOI: 10.3233/wor-210789] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND: Prior to the onset of the COVID-19 pandemic, occupational therapy (OT) services delivered through telehealth demonstrated comparative effectiveness to in-person services. At the onset of the pandemic, occupational therapy practitioners (OTPs) needed to continue delivering care to clients without being in-person. Many OT practitioners pivoted rapidly to telehealth, in many instances, with very little training. OBJECTIVE: The objective of this study was to describe the use of telehealth in occupational therapy during the early stages of the pandemic, and to explore how participants traversed the barriers. The perceived benefits and barriers to success with rapid telehealth adoption as experienced by OTPs, along with the specific strategies used to promote favorable outcomes may inform ongoing successful telehealth use in occupational therapy. METHOD: This study used a mixed-methods sequential explanatory design. Data was collected from September to December 2020 with an electronic survey. RESULTS: A total of 193 OTPs completed the survey, representing the delivery of OT services in 13 countries. Three main barriers to the use of telehealth were availability of materials, mastery of technology, and collaboration with caregivers/e-helpers. These barriers were negatively and significantly correlated with the participants’ confidence level in the use of telehealth. Participants overcame barriers by independently obtaining telehealth training, including training within one’s organization, support from social media, self-directed learning, and paid online telehealth webinars. CONCLUSION: Employers and educators can remove barriers to telehealth use by OTPs by providing a variety of learning opportunities and supports to enhance practitioners’ confidence, thus increasing the likelihood of continued use of telehealth as a powerful and gap-bridging delivery model in occupational therapy.
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Affiliation(s)
| | | | - Jana Cason
- Spalding University, Auerbach School of Occupational Therapy, Louisville, KY, USA
| | | | - Rachael Harasink
- College of Public Health, Temple University, Philadelphia PA, USA
| | - Kelsey Donehower
- College of Public Health, Temple University, Philadelphia PA, USA
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Castro R, Ribeiro-Alves M, Oliveira C, Romero CP, Perazzo H, Simjanoski M, Kapciznki F, Balanzá-Martínez V, De Boni RB. What Are We Measuring When We Evaluate Digital Interventions for Improving Lifestyle? A Scoping Meta-Review. Front Public Health 2022; 9:735624. [PMID: 35047469 PMCID: PMC8761632 DOI: 10.3389/fpubh.2021.735624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/29/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Lifestyle Medicine (LM) aims to address six main behavioral domains: diet/nutrition, substance use (SU), physical activity (PA), social relationships, stress management, and sleep. Digital Health Interventions (DHIs) have been used to improve these domains. However, there is no consensus on how to measure lifestyle and its intermediate outcomes aside from measuring each behavior separately. We aimed to describe (1) the most frequent lifestyle domains addressed by DHIs, (2) the most frequent outcomes used to measure lifestyle changes, and (3) the most frequent DHI delivery methods. Methods: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-ScR) Extension for Scoping Reviews. A literature search was conducted using MEDLINE, Cochrane Library, EMBASE, and Web of Science for publications since 2010. We included systematic reviews and meta-analyses of clinical trials using DHI to promote health, behavioral, or lifestyle change. Results: Overall, 954 records were identified, and 72 systematic reviews were included. Of those, 35 conducted meta-analyses, 58 addressed diet/nutrition, and 60 focused on PA. Only one systematic review evaluated all six lifestyle domains simultaneously; 1 systematic review evaluated five lifestyle domains; 5 systematic reviews evaluated 4 lifestyle domains; 14 systematic reviews evaluated 3 lifestyle domains; and the remaining 52 systematic reviews evaluated only one or two domains. The most frequently evaluated domains were diet/nutrition and PA. The most frequent DHI delivery methods were smartphone apps and websites. Discussion: The concept of lifestyle is still unclear and fragmented, making it hard to evaluate the complex interconnections of unhealthy behaviors, and their impact on health. Clarifying this concept, refining its operationalization, and defining the reporting guidelines should be considered as the current research priorities. DHIs have the potential to improve lifestyle at primary, secondary, and tertiary levels of prevention-but most of them are targeting clinical populations. Although important advances have been made to evaluate DHIs, some of their characteristics, such as the rate at which they become obsolete, will require innovative research designs to evaluate long-term outcomes in health.
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Affiliation(s)
- Rodolfo Castro
- Escola Nacional de Saúde Pública Sergio Arouca, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
- Instituto de Saúde Coletiva, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcelo Ribeiro-Alves
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Cátia Oliveira
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Carmen Phang Romero
- Centro de Desenvolvimento Tecnológico em Saúde, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Hugo Perazzo
- Instituto Nacional de Infectologia Evandro Chagas, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
| | - Mario Simjanoski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Flavio Kapciznki
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Instituto Nacional de Ciência e Tecnologia Translacional em Medicina, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Vicent Balanzá-Martínez
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, CIBERSAM, Valencia, Spain
| | - Raquel B. De Boni
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation (Fiocruz), Rio de Janeiro, Brazil
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Chang P, Zheng J. Updates in Cancer Rehabilitation Telehealth. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022; 10:332-338. [PMID: 36408472 PMCID: PMC9643960 DOI: 10.1007/s40141-022-00372-5] [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] [Accepted: 10/25/2022] [Indexed: 11/10/2022]
Abstract
Purpose of Review To describe the various uses of telehealth as it applies to cancer rehabilitation and to review recent findings since the onset of the COVID-19 pandemic. Recent Findings Telehealth has numerous applications in cancer rehabilitation including physiatry services, skilled therapies, exercise interventions, symptom management, and support groups. Numerous studies have shown that regular physician and skilled therapy services can be provided through telehealth platforms, though certain clinical situations may require in-person visits. Telehealth exercise-based interventions are feasible, safe, and can improve quality of life. Telehealth also may be an effective tool in symtom management and as a medium for support groups. Summary Telemedicine and telehealth platforms are effective tools in the field of cancer rehabilitation that not only provide increased safety and convenience for a burdened patient population but may also hold the potential to elevate beyond the current standard of care.
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Affiliation(s)
- Philip Chang
- Cedars Sinai Medical Center, 250 N. Robertson Blvd, Suite 403, Beverly Hills, Los Angeles, CA 90211 USA
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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: 66] [Impact Index Per Article: 22.0] [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.
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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
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Ben-Arye E, Paller CJ, Lopez AM, White S, Pendleton E, Kienle GS, Samuels N, Abbawaajii N, Balneaves LG. The Society for Integrative Oncology Practice Recommendations for online consultation and treatment during the COVID-19 pandemic. Support Care Cancer 2021; 29:6155-6165. [PMID: 33852088 PMCID: PMC8044504 DOI: 10.1007/s00520-021-06205-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/05/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The Society for Integrative Oncology (SIO) Online Task Force was created in response to the challenges facing continuity of integrative oncology care resulting from the COVID-19 pandemic. The Task Force set out to guide integrative oncology practitioners in providing effective and safe online consultations and treatments for quality-of-life-concerns and symptom management. Online treatments include manual, acupuncture, movement, mind-body, herbal, and expressive art therapies. METHODS The SIO Online Practice Recommendations employed a four-phase consensus process: (1) literature review and discussion among an international panel of SIO members, identifying key elements essential in an integrative oncology visit; (2) development, testing, and refinement of a questionnaire defining challenges and strategies; (3) refinement input from integrative oncology experts from 19 countries; and (4) SIO Executive Committee review identifying the most high-priority challenges and strategies. RESULTS The SIO Online Practice Recommendations address ten challenges, providing practical suggestions for online treatment/consultation. These include overcoming unfamiliarity, addressing resistance among patients and healthcare practitioners to online consultation/treatment, exploring ethical and medical-legal aspects, solving technological issues, preparing the online treatment setting, starting the online treatment session, maintaining effective communication, promoting specific treatment effects, involving the caregiver, concluding the session, and ensuring continuity of care. CONCLUSIONS The SIO Online Practice Recommendations are relevant for ensuring continuity of care beyond the present pandemic. They can be implemented for patients with limited accessibility to integrative oncology treatments due to geographic constraints, financial difficulties, physical disability, or an unsupportive caregiver. These recommendations require further study in practice settings.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, Lin, Zebulon, & Carmel Medical Centers, Clalit Health Services; Faculty of Medicine, Technion - Israel Institute of Technology, 35 Rothschild St, Haifa, Israel.
| | | | - Ana Maria Lopez
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shelley White
- Wellness and Integrative Health Center, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Eva Pendleton
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gunver S Kienle
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Institute for Applied Epistemology and Medical Methodology, University of Witten/Herdecke, Freiburg, Germany
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Nuria Abbawaajii
- College of Nursing, University of Manitoba, Winnipeg, MB, Canada
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