Best practice in the implementation of telehealth-based supportive cancer care: Using research evidence and discipline-based guidance

Spelten, Evelien; Hardman, Ruth; Pike, Kerryn E.; Yuen, Eva; Wilson, Carlene

doi:10.1016/j.pec.2021.04.006

Cited by 18 publications

(33 citation statements)

References 16 publications

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“…11,13 Other studies have started to outline how cancer care might be redefined postpandemic to better serve both patients and providers. 14,15 Given the emerging literature on experiences with telehealth and preferences for future care, we set out to understand both provider and cancer survivor experiences with telehealth and to solicit feedback on how to maximize the contributions of telehealth services that can improve quality of cancer care during and after the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic

Arem

Moses

Cisneros

et al. 2022

JCO Oncology Practice

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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.

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Section: Introductionmentioning

confidence: 99%

“…11,13 Other studies have started to outline how cancer care might be redefined postpandemic to better serve both patients and providers. 14,15…”

Section: Introductionmentioning

confidence: 99%

Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic

Arem

Moses

Cisneros

et al. 2022

JCO Oncology Practice

View full text Add to dashboard Cite

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“…Evidence shows contradictory views on the advantages of telehealth with regard to clinical effectiveness and enhanced access to care [ 14 ]. Furthermore, other studies have identified that barriers related to technological difficulties and low digital literacy might be equally present in the healthcare team [ 17 ]. The engagement of the healthcare team in the identification of barriers and facilitators for telehealth implementation is therefore crucial to enable its acceptance and usability.…”

Section: Expected Results and Discussionmentioning

confidence: 99%

“…Altogether, the scientific evidence points to the importance of exploring the optimal implementation strategy, along with identifying barriers and facilitators of telehealth adoption [ 17 ]. Considering the evidence-to-practice gap aligned with the “research waste” phenomenon [ 18 ], research endeavours have been deployed towards improving the acceptability and clinical relevance of health interventions, including those assisted by digital technology [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Telehealth Adoption in an Outpatient Oncology Ward: A Best Practice Implementation Project

et al. 2022

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Telehealth is increasingly taking place to support the transition of care and self-management of people living with cancer in outpatient oncology settings. Despite its recognised value, the scientific evidence points to disparities with regard to implementation of telehealth that might compromise the equity of access. Following the Joanna Briggs Institute (JBI) implementation approach, this project aims to promote the implementation of best practice recommendations for telehealth adoption in an outpatient oncology setting. Assisted by the Practical Application of Clinical Evidence System (PACES), the implementation process comprises three phases of (i) a baseline audit, (ii) feedback to the healthcare team and establishment of implementation strategies with the Getting Research into Practice (GRiP) tool, and (iii) a follow-up audit. The project is expected to allow the identification of barriers and facilitators for the implementation of telehealth in outpatient oncology and develop a strategy plan for its adoption, with the involvement of end-users and stakeholders. The successful adoption of telehealth according to the best available evidence will likely enhance equity of access to healthcare and quality of care at a distance.

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“…The rapid growth in different approaches to delivering health interventions provides new service delivery opportunities that may be advantageous over more traditional approaches such as face-to-face and telephone follow-up. For example, in terms of accessibility, face-to-face services require both patient and dietitian to be available at the same time and in the same place which may be difficult during cancer treatment [ 7 , 16 ]. Telephone-based services may be more accessible, but they still require patients and therapists to be available at the same time.…”

Section: Introductionmentioning

confidence: 99%

Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial

et al. 2022

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Background: Delay in dietetic service provision for upper gastrointestinal cancer exacerbates disease-related malnutrition and consequently increases morbidity and mortality. Dietetic services are usually referral-based and provided face-to-face in inpatient or outpatient settings, which can delay the commencement of nutrition care. The aim of this study was to provide intensive dietetic intervention close to the time of diagnosis for upper gastrointestinal cancer and assess the effect on quality-adjusted life years. Methods: A three-arm randomised controlled trial of adults newly diagnosed with upper gastrointestinal cancer was performed. A behavioural-based, individually tailored, symptom-directed nutrition intervention was provided in addition to usual care, delivered by a dietitian using a telephone (synchronously) or a mobile application (asynchronously) for 18 weeks, compared with a usual care control group. Data were collected at baseline, three, six, and twelve months post-randomisation. The primary outcome was quality-adjusted life years (EQ-5D-5L quality of life assessment tool). Data were analysed using linear mixed models. Results: One hundred and eleven participants were randomised. Quality-adjusted life years were not different in the intervention groups compared with control (telephone: mean (95% CI) 0.04 (0.43, 2.3), p = 0.998; App: −0.08 (−0.18, 0.02), p = 0.135) after adjustment for baseline, nutrition risk status, age, and gender. Survival was similar between groups over 12 months. The asynchronous mobile app group had a greater number of withdrawals compared with the telephone group. Conclusion: Early and intensive nutrition counselling, delivered at home, during anticancer treatment did not change quality-adjusted life years or survival over 12 months compared with usual care. Behavioural counselling alone was unable to achieve nutritional adequacy. Dietetic services delivered asynchronously using a mobile app had low acceptance for patients undergoing anticancer treatment. Trial Registration: 27 January 2017 Australian and New Zealand Clinical Trial Registry, ACTRN12617000152325.

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Best practice in the implementation of telehealth-based supportive cancer care: Using research evidence and discipline-based guidance

Cited by 18 publications

References 16 publications

Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic

Cancer Provider and Survivor Experiences With Telehealth During the COVID-19 Pandemic

Telehealth Adoption in an Outpatient Oncology Ward: A Best Practice Implementation Project

Effect of Early and Intensive Telephone or Electronic Nutrition Counselling Delivered to People with Upper Gastrointestinal Cancer on Quality of Life: A Three-Arm Randomised Controlled Trial

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