2020 年通过远程医疗和 2019 年面对面进行的综合肿瘤学咨询：COVID-19 世界大流行期间的范式转变。

Integrative Oncology Consultations Delivered via Telehealth in 2020 and In-Person in 2019: Paradigm Shift During the COVID-19 World Pandemic.

机构信息

The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

出版信息

Integr Cancer Ther. 2021 Jan-Dec;20:1534735421999101. doi: 10.1177/1534735421999101.

DOI:10.1177/1534735421999101

PMID:33655797

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7934055/

Abstract

BACKGROUND

The COVID-19 pandemic has catalyzed the use of mobile technologies to deliver health care. This new medical model has benefited integrative oncology (IO) consultations, where cancer patients are counseled about healthy lifestyle, non-pharmacological approaches for symptom management, and addressing questions around natural products and other integrative modalities. Here we report the feasibility of conducting IO physician consultations via telehealth in 2020 and compare patient characteristics to prior in-person consultations conducted in 2019.

METHODS

An integrated EHR-telemedicine platform was used for IO physician consultations. As in the prior in-person visits, patients completed pre-visit patient-reported outcome (PRO) assessments about common cancer symptoms [modified Edmonton Symptom Assessment Scale, (ESAS)], Measure Yourself Concerns and Wellbeing (MYCaW), and the PROMIS-10 to assess quality of life (QOL). Patient demographics, clinical characteristics, and PROs for new telehealth consultation in 2020 were compared to new in-person consultations in 2019 using -tests, chi-squared tests, and -Wilcoxon rank-sum test.

RESULTS

We provided telehealth IO consultations to 509 new patients from April 21, 2020, to October 21, 2020, versus 842 new patients in-person during the same period in 2019. Most were female (77 % vs 73%); median age (56 vs 58), and the most frequent cancer type was breast (48% vs 39%). More patients were seeking counseling on herbs and supplements (12.9 vs 6.8%) and lifestyle (diet 22.7 vs 16.9% and exercise 5.2 vs 1.8%) in the 2020 cohort than 2019, respectively. The 2020 telehealth cohort had lower symptom management concerns compared to the 2019 in-person cohort (19.5 vs 33.1%).

CONCLUSIONS

Delivering IO consultations using telehealth is feasible and meets patients' needs. Compared to patients seen in-person during 2019, patients having telehealth IO consultations in 2020 reported lower symptom burden and more concerns about lifestyle and herbs and supplements. Additional research is warranted to explore the satisfaction and challenges among patients receiving telehealth IO care.

摘要

背景

COVID-19 大流行加速了移动技术在医疗保健领域的应用。这种新的医疗模式使肿瘤整合医学（IO）咨询受益，癌症患者可以在咨询中获得关于健康生活方式、非药物治疗方法来管理症状以及解决有关天然产品和其他整合治疗方法的问题。在这里，我们报告了 2020 年通过远程医疗进行 IO 医生咨询的可行性，并将患者特征与 2019 年之前的面对面咨询进行了比较。

方法

使用集成电子健康记录-远程医疗平台进行 IO 医生咨询。与之前的面对面就诊一样，患者在就诊前完成有关常见癌症症状的患者报告结局（PRO）评估[改良埃德蒙顿症状评估量表（ESAS）]、测量自身关注和幸福感（MYCaW）以及 PROMIS-10 以评估生活质量（QOL）。使用 t 检验、卡方检验和 Wilcoxon 秩和检验比较 2020 年新远程医疗咨询的患者人口统计学、临床特征和 PRO 与 2019 年新面对面咨询的患者人口统计学、临床特征和 PRO。

结果

我们于 2020 年 4 月 21 日至 2020 年 10 月 21 日向 509 名新患者提供了远程医疗 IO 咨询，而 2019 年同期有 842 名新患者进行了面对面咨询。大多数患者为女性（77%比 73%）；中位年龄（56 岁比 58 岁），最常见的癌症类型为乳腺癌（48%比 39%）。与 2019 年相比，2020 年患者寻求草药和补品（12.9%比 6.8%）和生活方式（饮食 22.7%比 16.9%和运动 5.2%比 1.8%）咨询的患者更多。与 2019 年面对面就诊的患者相比，2020 年远程医疗就诊的患者报告的症状管理问题较少（19.5%比 33.1%）。