Department of Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, Victoria, Australia.
Medical Oncology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.
Cancer Med. 2022 Sep;11(17):3342-3351. doi: 10.1002/cam4.4700. Epub 2022 Apr 4.
Prior to 2020, the use of telehealth in cancer care was limited, but COVID-19 necessitated its rapid and widespread adoption into routine care delivery. This study aimed to evaluate perceptions of telehealth through a dyadic exploration of matched cancer patient- and clinician-reported acceptability data and to explore factors that may predict greater suitability for telehealth.
A prospective, cross-sectional, exploratory survey study assessed (matched) patient- and clinician-reported perceptions of telehealth consultations occurring at a metropolitan, tertiary-based cancer centre in Victoria, Australia.
One-hundred and fifty-five matched patient- and clinician-reported data were included. High rates of acceptability with telehealth were reported by patients (93%) and clinicians (91%), who mostly shared concordant views (86%). Factors significantly associated with increased acceptability for telehealth, included, for clinicians, greater familiarity with the patient (OR 8.20, 95% CI: 1.50-45.06, p = 0.02), and younger patient age (OR 1.06, 95% CI: 0.99-1.13, p = 0.05), and for patients was earlier stage disease (≤stage III) (OR 5.29, 95% CI: 1.08-25.82, p = 0.04). Lower acceptability for telehealth according to clinicians was associated with poorer patient performance status (OR 0.04, 95% CI 1.00-1.08, p = 0.04) and for patients with the need for an interpreter (0R 0.06, 95% CI: 0.008-0.51, p = 0.009).
While overall telehealth is acceptable in cancer care, our findings raise important implications for future service development, notably that it may be less optimal for patients with higher complexity of need-including those with more advanced disease, poorer performance status, those less well known to treating clinicians and those identified to have additional language barriers.
在 2020 年之前,远程医疗在癌症治疗中的应用受到限制,但 COVID-19 促使其迅速广泛应用于常规护理。本研究旨在通过对匹配的癌症患者和临床医生报告的可接受性数据进行二元探索,评估对远程医疗的看法,并探讨可能预测远程医疗更适合性的因素。
前瞻性、横断面、探索性调查研究评估了在澳大利亚维多利亚州一家大都市三级癌症中心进行的远程医疗咨询中,患者和临床医生报告的对远程医疗的看法。
共纳入 155 对匹配的患者和临床医生报告的数据。患者(93%)和临床医生(91%)报告的远程医疗可接受率均较高,他们的观点大多一致(86%)。与远程医疗接受度增加相关的因素包括,对于临床医生而言,更熟悉患者(OR 8.20,95%CI:1.50-45.06,p=0.02)和患者年龄较小(OR 1.06,95%CI:0.99-1.13,p=0.05),而对于患者而言,疾病分期较早(≤III 期)(OR 5.29,95%CI:1.08-25.82,p=0.04)。临床医生对远程医疗的接受程度较低与患者的表现状态较差(OR 0.04,95%CI 1.00-1.08,p=0.04)和需要口译员(OR 0.06,95%CI:0.008-0.51,p=0.009)有关。
虽然远程医疗在癌症护理中总体上是可以接受的,但我们的研究结果为未来服务的发展提出了重要的启示,特别是对于需要更高需求复杂性的患者——包括那些病情更严重、表现状态较差、治疗临床医生了解较少以及有额外语言障碍的患者,远程医疗可能不太理想。