J Natl Compr Canc Netw. 2021 Nov;19(Suppl_1):S21-S24. doi: 10.6004/jnccn.2021.7092.
The COVID-19 pandemic precipitated a rapid transformation in healthcare delivery. Ambulatory care abruptly shifted from in-person to telehealth visits with providers using digital video and audio tools to reach patients at home. Advantages to telehealth care include enhanced patient convenience and provider efficiencies, but financial, geographic, privacy, and access barriers to telehealth also exist. These are disproportionately greater for older adults and for those in rural areas, low-income communities, and communities of color, threatening to worsen preexisting disparities in tobacco use and health. Pandemic-associated regulatory changes regarding privacy and billing allowed many Cancer Center Cessation Initiative (C3I) programs in NCI-designated Cancer Centers to start or expand video-based telehealth care. Using 3 C3I programs as examples, we describe the methods used to shift to telehealth delivery. Although telephone-delivered treatment was already a core tobacco treatment modality with a robust evidence base, little research has yet compared the effectiveness of tobacco cessation treatment delivery by video versus phone or in-person modalities. Video-delivery has shown greater medication adherence, higher patient satisfaction, and better retention in care than phone-based delivery, and may improve cessation outcomes. We outline key questions for further investigation to advance telehealth for tobacco cessation treatment in cancer care.
COVID-19 大流行促使医疗保健服务迅速转变。非住院护理突然从面对面转为远程医疗,提供者使用数字视频和音频工具为在家的患者提供服务。远程医疗护理的优势包括增强了患者的便利性和提供者的效率,但远程医疗也存在财务、地理、隐私和获得方面的障碍。对于老年人以及农村地区、低收入社区和有色人种社区的人来说,这些障碍更大,有可能使吸烟和健康方面已存在的差异进一步恶化。与隐私和计费相关的大流行监管变化允许 NCI 指定癌症中心的许多癌症中心戒烟倡议 (C3I) 计划开始或扩大基于视频的远程医疗服务。我们以 3 个 C3I 计划为例,描述了转向远程医疗服务的方法。尽管电话治疗已经是一种具有强大证据基础的核心烟草治疗模式,但很少有研究比较视频与电话或面对面模式的烟草戒断治疗效果。与电话交付相比,视频交付显示出更高的药物依从性、更高的患者满意度和更好的护理保留率,并且可能改善戒烟效果。我们概述了进一步调查的关键问题,以推进癌症护理中远程医疗在烟草戒断治疗中的应用。