Oncology patients’ communication experiences during COVID-19: comparing telehealth consultations to in-person visits

Abstract

PurposeThe COVID-19 pandemic created significant disruptions in cancer care, much of which was transitioned to telehealth. Because telehealth alters the way clinicians and patients interact with one another, this investigation examined patients' perceptions of their communication with clinicians during the pandemic. Method Patients were recruited from the Cancer Support Community, Fight Colorectal Cancer, and a market research firm to participate in an online survey. In addition to demographic and health-related information, respondents completed measures of patient-centered communication and evaluated how their communication in telehealth sessions compared with in-person visits. Results From October to December 2020, 227 respondents (65.6% female, 64.6% Non-Hispanic White, 33.5% had 6 or more telehealth sessions, 55% were 50 or older) reported having some of their cancer care provided via telehealth. Respondents who were of racial/ethnic minorities, male, had more telehealth sessions, or had poorer mental health reported less patientcentered communication with clinicians. Most patients thought communication in telehealth sessions was "about the same" as in-person visits with respect to good communication (59%). However, patients thinking communication in telehealth sessions was "better" than in-person visits were more likely to be Hispanic (49%), Non-Hispanic Black (41%), under 50 years of age (32%), male (40%), and had more telehealth sessions (34%). Conclusion Respondents reporting less patient-centered communication during the pandemic-e.g., persons of racial/ethnic minorities and males-were also more likely to evaluate communication in telehealth sessions as better than in-person visits. Further research is needed to understand reasons underlying this finding. Cancer care clinicians should take into account patient preferences regarding telehealth care, which may be particularly important for racial and ethnic minority patients.

Exploring cancer patients’, caregivers’, and clinicians’ utilisation and experiences of telehealth services during COVID-19: A qualitative study

“…Negative themes include: limitations with physical examinations [10] , [14] , [15] , impacts on patient-clinician relationships [10] , communication barriers [10] , [12] , and technology barriers [12] , [13] , [14] , [15] , [16] . Literature demonstrates mixed views regarding the quality of communication through telehealth versus in-person consultations [17] .…”

Perspectives of older women with early breast cancer on telemedicine during post-primary treatment

“…Uniquely, our report focuses on patient perspectives on the pros and cons of using telemedicine as a means of post-primary treatment cancer care. Prior quantitative studies show high rates of satisfaction with telemedicine among older adults [21], and our report adds nuance to preferences for follow-up care elicited through open-ended questions. Our report also characterizes how and when older adults find telemedicine useful and preferable for follow-up cancer care in a forward-looking and patient-centered way and give insight to how improvements in telemedicine can be made.…”

“…Eighteen of these studies collected data prior to the COVID-19 pandemic [11]. Now, there is also a growing body of literature describing telemedicine acceptability in cancer care during the COVID-19 pandemic [12][13][14][15][16][17][18][19][20][21]. However, there are few studies investigating telemedicine acceptability in patients ≥ 65.…”

“…Some studies report results stratified by age, allowing for a small subgroup analysis of older patients. One such report found that 71% of elderly participants (n = 22/31) felt that communication using telemedicine was equal or superior to in-person visits and 87% (n = 29/31) felt clinicians could show equal caring and support through telemedicine as through in-person care [21]. Another publication with a median age of 63 found that breast cancer patients' relative satisfaction with telemedicine tracked with their perception of its usability and that this was not associated with demographic factors such as age [19].…”

Breast Cancer Disparities and the Digital Divide

“…Racial minorities reported greater satisfaction with telehealth appointments for oncology versus in-person visits [ 24 , 25 •]. In addition, at least one study found that underserved women used telehealth more frequently than affluent women when provided with the relevant materials and technology, emphasizing the importance of resource allocation, policy, and community outreach to increase telehealth access in underserved populations [ 26 ].…”