ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA 17055, USA.
Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL 35233, USA.
Curr Oncol. 2023 Sep 29;30(10):8916-8927. doi: 10.3390/curroncol30100644.
Diminished health-related quality of life (HRQOL) is common among cancer survivors but often amendable to rehabilitation. However, few access real-world rehabilitation services. Hybrid delivery modes (using a combination of in-clinic and synchronous telehealth visits) became popular during the COVID-19 pandemic and offer a promising solution to improve access beyond the pandemic. However, it is unclear if hybrid delivery has the same impact on patient-reported outcomes and experiences as standard, in-clinic-only delivery. To fill this gap, we performed a retrospective, observational, comparative outcomes study of real-world electronic medical record (EMR) data collected by a national outpatient rehabilitation provider in 2020-2021. Of the cases meeting the inclusion criteria ( = 2611), 60 were seen to via hybrid delivery. The outcomes evaluated pre and post-rehabilitation included PROMIS global physical health (GPH), global mental health (GMH), physical function (PF), and the ability to participate in social roles and activities (SRA). The patient experience outcomes included the Net Promoter Survey (NPS) and the Select Medical Patient-Reported Experience Measure (SM-PREM). A linear and logistic regression was used to examine the between-group differences in the PROMIS and SM-PREM scores while controlling for covariates. The hybrid and in-clinic-only cases improved similarly in all PROMIS outcomes (all < 0.05). The association between the delivery mode and the likelihood of achieving the minimal important change in the PROMIS outcomes was non-significant (all > 0.05). No between-group differences were observed in the NPS or SM-PREM scores (all > 0.05). Although more research is needed, this real-world evidence suggests that hybrid rehabilitation care may be equally beneficial for and acceptable to cancer survivors and supports calls to expand access to and reimbursement for telerehabilitation.
癌症幸存者的健康相关生活质量（HRQOL）通常会下降，但通常可以通过康复来改善。然而，很少有人能够获得实际的康复服务。混合交付模式（结合门诊和同步远程医疗访问）在 COVID-19 大流行期间变得流行，为改善大流行后的康复服务提供了一个有前途的解决方案。然而，混合交付模式对患者报告的结果和体验是否与标准的门诊服务相同尚不清楚。为了填补这一空白，我们对一家全国性门诊康复服务提供商在 2020-2021 年期间收集的真实电子病历（EMR）数据进行了回顾性、观察性、比较性结果研究。符合纳入标准的病例（n=2611）中，有 60 例采用混合交付模式就诊。康复前后评估的结果包括 PROMIS 全球身体健康（GPH）、全球心理健康（GMH）、身体功能（PF）和参与社会角色和活动的能力（SRA）。患者体验结果包括净推荐值调查（NPS）和 Select Medical 患者报告体验测量（SM-PREM）。线性和逻辑回归用于检查 PROMIS 和 SM-PREM 评分的组间差异，同时控制协变量。混合交付模式和门诊服务模式的病例在所有 PROMIS 结果方面都有类似的改善（均<0.05）。交付模式与 PROMIS 结果达到最小有意义变化的可能性之间的关联不显著（均>0.05）。在 NPS 或 SM-PREM 评分方面未观察到组间差异（均>0.05）。尽管需要更多的研究，但这些真实世界的证据表明，混合康复护理可能对癌症幸存者同样有益且可接受，并支持扩大远程康复的机会和报销范围的呼吁。
