Baygi Fereshteh, Bitz Trabjerg Theis, Jensen Lars Henrik, Munch Storsveen Maria, Wehberg Sonja, Sisler Jeffrey James, Søndergaard Jens, Gilså Hansen Dorte
Department of Public Health, Research Unit of General Practice, University of Southern Denmark, Campusvej 55, Odense, 5230, Denmark, 45 65502348.
Department of Oncology, Lillebælt University Hospital, Vejle, Denmark.
JMIR Cancer. 2025 Feb 11;11:e60158. doi: 10.2196/60158.
Patients with cancer need coordinated care for both treatment and concurrent health conditions. This requires collaboration among specialists when using telemedicine services, emphasizing the importance of care continuity.
This study aimed to explore the effects of cross-sectorial video consultation involving oncologists, general practitioners, and patients with cancer on patients' perceived coordination of care, compared with usual care.
This study describes the primary outcomes from a 7-month follow-up of patients in the Partnership Project, a randomized clinical trial. Patients in the intervention group were randomized to receive a "partnership consultation," a shared video consultation with an oncologist, general practitioners, and the patient, in addition to their usual care. Questionnaires were completed for both groups at baseline and 7 months to assess the primary outcome, "global assessment of inter-sectorial cooperation," from the Danish questionnaire "Patients' attitude to the health care service." The questionnaire also included 2 single items and 5 index scales, examining patients' attitude toward cooperation in the health care system. Change in perceived global coordination from baseline to 7 months was compared between intention-to-treat groups using generalized estimating equations in a linear regression model.
A total of 278 participants were randomized with 1:1 allocation, with 80 patients receiving the intervention. Further, 210 patients completed the questionnaire at baseline, while 118 responded at 7-month follow-up. The estimated difference in the primary outcome between usual care (-0.13, 95% CI -0.38 to 0.12) and intervention (0.11, 95% CI -0.11 to 0.34) was 0.24 (95% CI -0.09 to 0.58) and not statistically significant (P=.15).
Low rates of intervention completion and high levels of missing data compromised the interpretability of our study. While we observed a high level of global assessment of coordination, the estimated intervention effect was smaller than anticipated, with no significant difference in perceived coordination between control and intervention groups. Future studies should explore strategies like patient incentives to increase response rate and improve the evaluation of this innovative health care model.
癌症患者在治疗及并发健康问题时需要协调护理。使用远程医疗服务时，这需要专科医生之间的协作，强调了护理连续性的重要性。
本研究旨在探讨肿瘤学家、全科医生和癌症患者参与的跨部门视频会诊与常规护理相比，对患者感知的护理协调性的影响。
本研究描述了一项随机临床试验“合作项目”中患者7个月随访的主要结果。干预组患者除接受常规护理外，还被随机分配接受“合作会诊”，即与肿瘤学家、全科医生和患者进行的共享视频会诊。在基线和7个月时，两组患者均完成问卷调查，以评估丹麦问卷“患者对医疗服务的态度”中的主要结果“跨部门合作的总体评估”。该问卷还包括2个单项和5个指标量表，用于考察患者对医疗系统中合作的态度。在线性回归模型中，使用广义估计方程比较意向性治疗组从基线到7个月时感知的总体协调性变化。
共有278名参与者按1:1分配进行随机分组，80名患者接受干预。此外，210名患者在基线时完成了问卷调查，118名患者在7个月随访时做出了回应。常规护理组（-0.13，95%CI -0.38至0.12）和干预组（0.11，95%CI -0.11至0.34）主要结果的估计差异为0.24（95%CI -0.09至0.58），无统计学意义（P = 0.15）。
干预完成率低和大量数据缺失影响了我们研究的可解释性。虽然我们观察到协调性的总体评估水平较高，但估计的干预效果小于预期，对照组和干预组在感知协调性方面无显著差异。未来的研究应探索如患者激励等策略，以提高回应率并改进对这种创新医疗模式的评估。
