Caraceni Augusto, Pellegrini Chiara, Shkodra Morena, Zecca Ernesto, Bracchi Paola, Lo Dico Silvia, Caputo Mariangela, Zappata Simonetta, Zito Emanuela, Brunelli Cinzia
Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
BMJ Support Palliat Care. 2022 Jun 16. doi: 10.1136/bmjspcare-2022-003585.
During the COVID-19 pandemic, telemedicine (TM) emerged as an important mean to reduce risks of transmission, yet delivering the necessary care to patients. Our aim was to evaluate feasibility, characteristics and satisfaction for a TM service based on phone/video consultations for patients with cancer attending an outpatient palliative care clinic during COVID-19 pandemics.
A longitudinal observational study was conducted from April to December 2020. Consecutive patients were screened for video consultations feasibility. Either patients or their caregivers received video/phone consultations registering reason and intervention performed. Those contacted at least twice were eligible for experience of care assessment.
Video consultations were feasible in 282 of 572 screened patients (49%, 95% CI 45% to 52%); 112 patients among the 572 had at least two phone/video consultations and 12 of them had one or more video consultations. Consultations were carried out with patients (56%), caregivers (30%) or both (14%). 63% of the consultations were requested by the patients/caregivers. Reasons for consultation included uncontrolled (66%) or new symptom onset (20%), therapy clarifications (37%) and updates on diagnostic tests (28%). Most interventions were therapy modifications (70%) and appointments' rescheduling (51%). 49 patients and 19 caregivers were interviewed, reporting good care experience (average of 1-5 satisfaction score of 3.9 and 4.2, respectively). The majority (83% and 84%) declared they would use TM after the pandemics.
Although feasibility is still limited for some patients, TM can be a satisfactory alternative to in-person visits for palliative care patients in need of limiting access to the hospital.
在新冠疫情期间，远程医疗成为降低传播风险同时为患者提供必要医疗服务的重要手段。我们的目的是评估在新冠疫情期间，为门诊姑息治疗诊所的癌症患者提供基于电话/视频会诊的远程医疗服务的可行性、特点及满意度。
于2020年4月至12月进行了一项纵向观察性研究。对连续的患者进行视频会诊可行性筛查。患者或其护理人员接受视频/电话会诊，并记录会诊原因及实施的干预措施。至少接受两次会诊的患者有资格进行护理体验评估。
在572例接受筛查的患者中，282例（49%，95%可信区间45%至52%）可行视频会诊；572例患者中有112例至少接受了两次电话/视频会诊，其中12例进行了一次或多次视频会诊。会诊对象包括患者（56%）、护理人员（30%）或两者（14%）。63%的会诊由患者/护理人员提出。会诊原因包括症状未得到控制（66%）或出现新症状（20%）、治疗说明（37%）以及诊断检查结果更新（28%）。大多数干预措施为调整治疗方案（70%）和重新安排预约时间（51%）。对49例患者和19例护理人员进行了访谈，他们均表示护理体验良好（满意度平均评分为1至5分，分别为3.9分和4.2分）。大多数（83%和84%）表示疫情结束后仍会使用远程医疗。
尽管对部分患者而言可行性仍有限，但对于需要减少前往医院次数的姑息治疗患者，远程医疗可成为令人满意的门诊替代方式。
