Department of Palliative, Rehabilitation and Integrative Medicine (K.K.S., A.B.A., A.R.D.M., A.J.R., L.T., P.A.S., E.B., D.H.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Department of Biostatistics (X.C., D.L.U.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
J Pain Symptom Manage. 2024 Jun;67(6):525-534.e1. doi: 10.1016/j.jpainsymman.2024.02.572. Epub 2024 Mar 10.
Few studies have examined patient preferences for telehealth in palliative care after the availability of COVID-19 vaccines. We examined patient preferences for video versus in-person visits and factors contributing to preferences in the postvaccine era.
This is a cross-sectional survey of patients who were seen at our palliative care clinic between April 2021 and March 2022. Patients were surveyed directly their preference for either video or in-person visits for outpatient palliative care (primary outcome). We also surveyed preferences including convenience, cost, wait time, and perceptions of COVID-19 safety regarding their palliative virtual-video visit. We examined clinical factors associated with preferences with multivariate logistic regression.
About 200 patients completed the survey. 132 (67%, 95% confidence interval [CI]: 60%, 74%) preferred virtual-video, while 16 (8%) preferred in-person visits during the COVID-19 pandemic. About 120 (61%, 95%CI: 54%, 68%) preferred virtual-video after the pandemic. Patients perceived virtual-video favorably regarding travel and related costs (179 [91%]), convenience (175 [88%]), and wait time (136 [69%]). Multivariable analysis showed concerns for catching COVID-19 from healthcare providers (odds ratio [OR]: 4.20; 95%CI: 1.24-14.25; P = 0.02) and feeling comfortable with computers or mobile devices (OR: 4.59; 95%CI: 1.02, 20.60; P = 0.047) were significantly associated with preferring virtual-video. Patients who were of Hispanic or Latino ethnicity (OR: 0.25; 95%CI: 0.09, 0.71) and had increased dypsnea (OR: 0.74; 95%CI: 0.59, 0.93) were less likely to prefer video over in-person.
Patients expressed strong preference for video over in-person visits in the outpatient palliative care setting.
在 COVID-19 疫苗问世后，很少有研究调查晚期癌症患者对远程医疗的偏好。我们调查了患者对视频就诊和面对面就诊的偏好，以及在疫苗接种后时代影响偏好的因素。
这是一项在我们姑息治疗诊所于 2021 年 4 月至 2022 年 3 月期间就诊的患者的横断面调查。直接调查患者对门诊姑息治疗的视频或面对面就诊的偏好（主要结局）。我们还调查了与虚拟视频就诊相关的便利性、成本、等待时间和对 COVID-19 安全的看法。我们使用多变量逻辑回归检查与偏好相关的临床因素。
约 200 名患者完成了调查。在 COVID-19 大流行期间，132 名患者（67%，95%置信区间[CI]：60%，74%）更喜欢视频就诊，16 名患者（8%）更喜欢面对面就诊。大流行后，约 120 名患者（61%，95%CI：54%，68%）更喜欢视频就诊。患者对虚拟视频就诊的旅行和相关费用（179 人[91%]）、便利性（175 人[88%]）和等待时间（136 人[69%]）评价较高。多变量分析显示，对从医疗保健提供者处感染 COVID-19 的担忧（比值比[OR]：4.20；95%CI：1.24-14.25；P=0.02）和对计算机或移动设备的舒适度（OR：4.59；95%CI：1.02，20.60；P=0.047）与偏好虚拟视频显著相关。西班牙裔或拉丁裔患者（OR：0.25；95%CI：0.09，0.71）和呼吸困难增加的患者（OR：0.74；95%CI：0.59，0.93）不太可能选择视频就诊而不是面对面就诊。
患者在门诊姑息治疗环境中表达了对视频就诊的强烈偏好，而不是面对面就诊。
