Completion rate and impact on physician–patient relationship of video consultations in medical oncology: a randomised controlled open-label trial

Abstract

BackgroundMobile phone video call applications generally did not undergo testing in randomised controlled clinical trials prior to their implementation in patient care regarding the rate of successful patient visits and impact on the physician–patient relationship.MethodsThe National Center for Tumour Diseases (NCT) MOBILE trial was a monocentric open-label randomised controlled clinical trial of patients with solid tumours undergoing systemic cancer therapy with need of a follow-up visit with their consulting physician at outpatient clinics. 66 patients were 1:1 randomised to receive either a standard in-person follow-up visit at outpatient clinics or a video call via a mobile phone application. The primary outcome was feasibility defined as the proportion of patients successfully completing the first follow-up visit. Secondary outcomes included success rate of further video calls, time spent by patient and physician, patient satisfaction and quality of physician–patient relationship.FindingsSuccess rate of the first follow-up visit in the intention-to-treat cohort was 87.9% (29 of 33) for in-person visits and 78.8% (26 of 33) for video calls (relative risk: RR 0.90, 95% CI 0.70 to 1.13, p=0.51). The most common reasons for failure were software incompatibility in the video call and no-show in the in-person visit arm. The success rate for further video visits was 91.7% (11 of 12). Standardised patient questionnaires showed significantly decreased total time spent and less direct costs for patients (Δmean −170.8 min, 95% CI −246 min to −95.5 min), p<0.0001; Δmean −€14.37, 95% CI −€23.9 to −€4.8, p<0.005) and comparable time spent for physicians in the video call arm (Δmean 0.5 min, 95% CI −5.4 min to 6.4 min, p=0.86). Physician–patient relationship quality mean scores assessed by a validated standardised questionnaire were higher in the video call arm (1.13-fold, p=0.02).InterpretationFollow-up visits with the tested mobile phone video call application were feasible but software compatibility should be critically evaluated.Trial registration numberDRKS00015788.

Use of Telepharmacy To Support Patients Using Oral Antineoplastic Agents: A Pilot Study

“…The tool suggested in this work can be applied in different scenarios of pharmaceutical care. Among possibilities of pharmacist teleconsultation's applications, we can mention the identi cation of inappropriate medication use [20], ADR identi cation [4], [20], [21], the detection of drug-related problems [4], [20], and improved adherence [4]; often with positive feedbacks from patients and professionals about the telemedicine use [12], including phone calls [22].…”

“…Besides face-to-face communication is the ideal model for patient care, it must be considered the availability of technologies capable of virtually supporting a large part of the work performed by health professionals, if necessary [7]. Thus, telemedicine applications can facilitate patient access to specialized medical care remotely and, therefore, can be ideally suited to the medical oncology environment [12].…”

Akzeptanz der Videosprechstunde unter Patienten/innen mit entzündlich rheumatischen Erkrankungen ist geschlechts- und ortsabhängig – Ergebnisse einer Online-Umfrage unter Patienten/innen und Ärzten/innen

“…Hierbei sparen sich Patienten/innen Zeit und ggf. die Fahrt zum Arzt [9]. Statt einer Videosprechstunde könnte auch eine Telefonkonferenz diese Zwecke erfüllen, wobei die Videosprechstunde Vorteile bietet durch Augenkontakt und eine grobe Einschätzung des aktuellen Gelenkstatus ermöglicht mittels virtueller Gelenkuntersuchung, die bei "RheumNow" demonstriert wird [12].…”

“…Anderseits könnte die Videosprechstunde auch für Patienten/innen mit geringem Einkommen, die über die technischen Voraussetzungen verfügen, ein Vorteil sein, denn es konnte gezeigt werden, dass die Videosprechstunde nicht nur eine Zeitersparnis, sondern auch geringere direkte Kosten, wie z. B. Fahrtkosten, für den/die Patienten/innen darstellt [9]. Der Zeitaufwand für die Ärzte/innen blieb unverändert, unabhängig ob eine Videosprechstunde oder Sprechstunde vor Ort stattgefunden hat [9].…”

“…B. Fahrtkosten, für den/die Patienten/innen darstellt [9]. Der Zeitaufwand für die Ärzte/innen blieb unverändert, unabhängig ob eine Videosprechstunde oder Sprechstunde vor Ort stattgefunden hat [9]. Dieser Aspekt sollte unbedingt auch bei der Honorierung der Videosprechstunde berücksichtigt werden.…”