Exploring patient experiences with a telehealth approach for the PRO-ACTIVE trial intervention in head and neck cancer patients

Abstract

Introduction Following the COVID-19 directive to cease non-essential services, a rapid shift was made in the delivery of Speech Language Pathology (SLP) dysphagia management in the 3-arm, randomized PRO-ACTIVE trial. To inform future programs, this study explored patients’ experiences with telehealth when the planned in-person SLP intervention was moved to a telehealth modality. Methods A theory-guided qualitative descriptive approach was used. Willing participants who had received at least one telehealth swallowing therapy session participated in a one-time semi-structured interview. Interview transcripts were subjected to a standard qualitative content/theme analysis. Researchers reviewed all transcripts and used a multi-step analysis process to build a coding framework through consensus discussion. Summaries and key messages were generated for each code. Results Eleven participants recounted their telehealth experiences and reported feeling satisfied, comfortable and confident with the session(s). They identified that previous experience with teleconferencing, access to optimal technical equipment, clinician skill, and caregiver assistance facilitated their telehealth participation. Participants highlighted that telehealth was beneficial as it reduced commuting time, COVID-19 exposure and fatigue from travel; and also allowed caregiver participation particularly during COVID. In comparing their in-person SLP sessions to telehealth sessions, limitations were also identified, including: lack of previous experience with and/or poor access to technology, and less opportunity for personalization. Participants indicated that use of phone alone was less preferred than an audio/video platform. Discussion Patients reported that overall, telehealth sessions did not compromise their learning experience when compared to in-person sessions. Patients benefited from use of telehealth in several ways despite some limitations of the use of technology. Patient feedback about telehealth provides an important perspective that may be critical to inform best practices for care delivery.

Patient experience of telehealth appointments in head and neck cancer services during the COVID‐19 pandemic

“…Survey responses indicated that overall, participants were satisfied with their telehealth appointments and were willing to accept this model of working into HNC pathways. These findings are in keeping with other studies exploring patient experience of telehealth in SLT services (Burns et al, 2012;Khan et al, 2022;Weidner & Lowman, 2020).…”

“…Telehealth has also been received positively by participants in SLT research trials. Khan et al (2022) explored patient experience of the use of telehealth for the PRO-ACTIVE trial intervention during the COVID-19 pandemic. Participants reported that telehealth did not compromise their learning and they described feeling 'satisfied, comfortable and confident' following their sessions.…”

Patient and caregiver experience with telehealth for surgical cancer care: A qualitative study

“…Notably, with the COVID-19 pandemic resulting in unprecedented telemedicine growth among healthcare organizations, 1-4 many patients may be experiencing their first several telemedicine visits. 30,31 Our study found that allowing patients to have mock telehealth visits was wellreceived, suggesting that improving patient comfort and managing expectations of telehealth may improve the patient experience.…”

“…Our findings suggest positive experiences with telehealth for preanesthesia and postoperative visits among patients and caregivers of various cancer types (e.g., gastrointestinal, genitourinary, and gynecologic). Common benefits of telehealth included time and cost savings associated with travel, which have been previously documented in the literature in cancer care 13,16,19,20,22,27–31 . Since surgical recovery can involve fatigue, one surgery‐specific benefit was allowing surgical patients to avoid having to travel while fatigued and in recovery.…”

“…Common benefits of telehealth included time and cost savings associated with travel, which have been previously documented in the literature in cancer care. 13,16,19,20,22,[27][28][29][30][31] Since surgical recovery can involve fatigue, one surgery-specific benefit was allowing surgical patients to avoid having to travel while fatigued and in recovery. Similar sentiments were expressed in another study on postoperative visits among patients with cancer.…”