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Alashek WA, Ali SA. Satisfaction with telemedicine use during COVID-19 pandemic in the UK: a systematic review. Libyan J Med 2024; 19:2301829. [PMID: 38197179 PMCID: PMC10783830 DOI: 10.1080/19932820.2024.2301829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 12/31/2023] [Indexed: 01/11/2024] Open
Abstract
Background: Telemedicine became a fundamental part of healthcare provision during COVID-19 pandemic. An evaluation of telemedicine-associated satisfaction helps the service develop more viable applications. This review evaluated the satisfaction of healthcare users and providers and their willingness to use this modality in future.Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A search on empirical articles published between March 2020 and December 2022 was performed on 'PubMed' and 'Scopus' databases. Findings that reported on satisfaction of patients, families and caregivers as well as clinicians were extracted and analysed. Quality of included studies was assessed. After applying inclusion and exclusion criteria, the review included 27 eligible studies.Results: Data was found from a variety of emergency and non-emergency departments of primary, secondary, and specialised healthcare. Almost all studies were undertaken within the NHS. There were many tools that measured satisfaction. Satisfaction was high among recipients of healthcare, scoring 9-10 on a scale of 0-10 or ranging from 73.3% to 100%. Convenience was rated high in every specialty examined. Satisfaction of clinicians was high throughout the specialities despite connection failure and concerns about confidentiality of information. Nonetheless, studies reported perception of increased barriers to accessing care and inequalities for vulnerable patients especially in older people. In general, willingness to use telemedicine in future was high in the recipients as well as the providers of healthcare.Conclusion: COVID-19 pandemic has transformed healthcare in the UK and promoted a revolution in telemedicine applications. Satisfaction was high among both recipient and provider of healthcare. Telemedicine managed to provide a continued care throughout the pandemic while maintaining social distance. The current review presented commendable evidence to encourage different specialities to engage in telemedicine application.
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Affiliation(s)
- WA. Alashek
- Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - SA. Ali
- Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Cabrera Chien L, Uranga C, Katheria V. Telemedicine in geriatric oncology - lessons learned from the COVID-19 experience. Curr Opin Support Palliat Care 2024; 18:100-105. [PMID: 38652459 DOI: 10.1097/spc.0000000000000697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
PURPOSE OF REVIEW Telemedicine quickly became integrated into healthcare caused by the Coronavirus 19 (COVID-19) pandemic. Rapid use of telemedicine into healthcare systems was supported by the World Health Organization and other prominent national organizations to reduce transmission of the virus while continuing to provide access to care. In this review, we explored the effect of this swift change in care and its impact on older adults with cancer. RECENT FINDINGS Older adults are susceptible to the COVID-19 virus caused by various risk factors, such as comorbidity, frailty, decreased immunity, and cancer increases vulnerability to infection, hospitalization, and mortality. We found three major themes emerged in the literature published in the past 18 months, including access to care, telemedicine modes of communication, and the use of technology by older adults with cancer. These findings have brought insight into issues regarding healthcare disparities. SUMMARY The utilization of telemedicine by older adults with cancer has potential future benefits with the integration of technology preparation prior to the patient's initial visit and addressing known health disparities. The hybrid model of care provides in-person and or remote access to clinicians which may allow older adults with cancer the flexibility needed to obtain quality cancer care.
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Shih KK, Arechiga AB, Chen X, Urbauer DL, De Moraes AR, Rodriguez AJ, Thomas L, Stanton PA, Bruera E, Hui D. Telehealth Preferences Among Patients With Advanced Cancer in the Post COVID-19 Vaccine Era. J Pain Symptom Manage 2024; 67:525-534.e1. [PMID: 38467349 DOI: 10.1016/j.jpainsymman.2024.02.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 01/30/2024] [Accepted: 02/28/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSION Patients expressed strong preference for video over in-person visits in the outpatient palliative care setting.
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Affiliation(s)
- Kaoswi K Shih
- 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
| | - Adrienne B Arechiga
- 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
| | - Xi Chen
- Department of Biostatistics (X.C., D.L.U.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Diana L Urbauer
- Department of Biostatistics (X.C., D.L.U.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Aline Rozman De Moraes
- 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
| | - Ashley J Rodriguez
- 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
| | - Lisa Thomas
- 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
| | - Penny A Stanton
- 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
| | - Eduardo Bruera
- 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
| | - David Hui
- 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.
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Greenup EP, Best D. Comparison of patient responses to telehealth satisfaction surveys in rural and urban populations in Queensland. AUST HEALTH REV 2023; 47:559-568. [PMID: 37635328 DOI: 10.1071/ah23116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 08/29/2023]
Abstract
Objective Telehealth has for many years been identified as a potential contributor to reducing healthcare access inequality. For these benefits to be realised, patients must be accepting and satisfied with the delivery of healthcare in this manner. Measuring patient satisfaction across a large geographical area is important to ensure that investments in telehealth are delivering the benefits that are intended. Methods A brief survey was automatically issued on completion of a patient's telehealth appointment, requesting patient feedback on their experience and information on the location of where they participated in the appointment. These results were compared to an article review which sought examples of other patient satisfaction measures that compared rural and urban populations. Results No significant correlations between survey responses and established demographic indices were found. When stratified by the Modified Monash Model band from which the patient participated in their telehealth appointment from, an ANOVA test determined that rurality was not a predictor of survey response. A review of articles found four articles that compared rural and urban satisfaction responses. Conclusion No evidence of a patient's location influencing their satisfaction with telehealth was observed. This may be attributed to a variety of technical improvements introduced over the past 5-10 years that have made participating in telehealth appointments less technically demanding and more accessible. Telehealth is likely to be contributing to a reduction in healthcare access inequality in Queensland.
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Affiliation(s)
- Edwin Phillip Greenup
- Clinical Excellence Queensland, Queensland Health, Brisbane, Level 2, 15 Butterfield Street, Herston, Qld 4006, Australia
| | - Daniel Best
- Clinical Excellence Queensland, Queensland Health, Brisbane, Level 2, 15 Butterfield Street, Herston, Qld 4006, Australia
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Stoeklé H, Ladrat L, Landrin T, Beuzeboc P, Hervé C. Bio-ethical issues in oncology during the first wave of the COVID-19 epidemic: A qualitative study in a French hospital. J Eval Clin Pract 2023; 29:925-933. [PMID: 36106460 PMCID: PMC9538223 DOI: 10.1111/jep.13766] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Using a specific bioethical theory (=global bioethics) and method (=a posteriori), we try here to identify and evaluate the bio-ethical issues raised by the COVID-19 pandemic, and possible solutions, to improve the management of cancer patients at the hospital in future pandemics, before the emergence of vaccines or scientifically validated treatments. MATERIALS & METHODS Our work is based primarily on the clinical experience of three oncologists from the oncology department of Foch Hospital in France, who were on the frontline during the first wave of the epidemic. We compared their perceptions with published findings, to complete or nuance their views. RESULTS Three bio-ethical issues were identified, and possible solutions to these problems were evaluated: (1) scientific evidence versus lack of time → the creation of emergency multidisciplinary team meetings (MTM); (2) healthcare equality versus lack of resources → the development of telemedicine; (3) individual liberties versus risk of contamination → role of cancer patients' associations, psychologists and bioethicists. CONCLUSION We consider the creation of an emergency MTM, in particular, in addition to a true ethics committee with real competence in bioethics, to be a first solution that would be easy to implement in hospitals in many countries.
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Affiliation(s)
| | - Laure Ladrat
- Department of Oncology and Supportive CareFoch HospitalSuresnesFrance
| | - Terence Landrin
- Department of Supportive CareCognacq‐Jay HospitalParisFrance
| | - Philippe Beuzeboc
- Department of Oncology and Supportive CareFoch HospitalSuresnesFrance
| | - Christian Hervé
- Department of Ethics and Scientific IntegrityFoch HospitalSuresnesFrance
- Medical SchoolParis Cité UniversityParisFrance
- Medical SchoolVersailles‐Saint‐Quentin‐en‐Yvelines University (UVSQ)Montigny‐le‐BretonneuxFrance
- International Academy of Medical Ethics and Public HealthParis Cité UniversityParisFrance
- Veterinary Academy of FranceParisFrance
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Addario B, Astratinei V, Binder L, Geissler J, Horn MK, Krebs LU, Lewis B, Oliver K, Spiegel A. A New Framework for Co-Creating Telehealth for Cancer Care with the Patient Community. THE PATIENT 2023; 16:415-423. [PMID: 37493895 PMCID: PMC10409807 DOI: 10.1007/s40271-023-00642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
The increased use of telehealth in cancer care during the coronavirus disease 2019 pandemic has added to our knowledge and experience of the modality with benefits in terms of efficacy, cost, and patient and healthcare professional experience reported. However, telehealth has also been found not to be universally available to all patients with cancer, nor to be appropriate for every healthcare interaction; additionally, not all patients prefer it. Now that coronavirus disease restrictions have essentially ended and an opportunity to re-assess telehealth provision in cancer care presents, we offer a framework that aims to ensure that the needs and preferences of the patient community are included in the development of telehealth provision. Stakeholders in this process include patients, patient advocates, healthcare providers, healthcare services commissioners, managers, and policy makers. The framework outlines how patient advocates can work with other stakeholders as equal partners at all stages of telehealth service development. The patient advocate community has a unique understanding of the patient perspective as well as expertise in healthcare design and delivery. This enables advocates to contribute to shaping telehealth provision, from policy and guideline formulation to patient navigation. Appropriate resources, education and training may be needed for all stakeholders to support the development of an effective telehealth system. Together with other stakeholders, patient advocates can make an important contribution to optimizing appropriate patient-centred telehealth provision in cancer care.
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Affiliation(s)
| | | | | | | | - Marcia K. Horn
- ICAN, International Cancer Advocacy Network, Phoenix, AZ USA
| | - Linda U. Krebs
- International Society of Nurses in Cancer Care, Vancouver, BC Canada
| | | | - Kathy Oliver
- International Brain Tumour Alliance, Tadworth, Surrey UK
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van Puffelen AJ, van der Sar LJ, Moerman F, Eicher M, Oldenmenger WH. Cancer care during the Covid-19 pandemic from the perspective of patients and their relatives: A qualitative study. Heliyon 2023; 9:e19752. [PMID: 37809531 PMCID: PMC10559054 DOI: 10.1016/j.heliyon.2023.e19752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/17/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023] Open
Abstract
Objective The Covid -19 pandemic has had a major influence on the organization of cancer care. Little is known about how patients with cancer and their relatives experienced this period. This study explored these experiences and levels of distress and resilience of Dutch cancer patients and their family caregivers during the Covid-19 pandemic. Methods The qualitative design included in-depth interviews with cancer patients and their family caregivers to explore their experiences. The distress thermometer (NCCN-DT) and resilience questionnaire (CD-RISC2) were used for contextualizing. Data were analyzed by thematic analysis and descriptive statistics. Results 40 patients with breast cancer, lung cancer, colorectal cancer, or melanoma who received active systemic anti-cancer therapy, were included with a median age of 60 years[SD11.1]. We also included fourteen family caregivers with a median age of 60 years [SD8.6].Five themes were identified: (1) Living with cancer during Covid-19, (2) Changes in cancer care, (3) Information and support, (4) Safety inside the hospital, and (5) Impact of vaccination. The mean score of NCCN-DT was 2.9[SD2.4] for patients and 4.3[SD2.7] for family caregivers. Mean score of CD-RISC2 was 6.6[SD1.4] for patients and 7.2[SD1] for family caregivers. Conclusions Patients felt vulnerable during the pandemic and were strict in following the safety precautions. The limited companionship of family caregivers was experienced as the biggest restraint. In general, they felt safe inside the hospital. Vaccination brought some relief. Patients were satisfied with the provided support, but areas were identified which are amenable for redesigning care processes.
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Affiliation(s)
- Andrea J. van Puffelen
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Lisa J. van der Sar
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Frederique Moerman
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
| | - Manuela Eicher
- Institute of Higher Education and Research in Healthcare (IUFRS), Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Lausanne University Hospital (CHUV) Department of Oncology, Lausanne, Switzerland
| | - Wendy H. Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, P.O. Box 2040, 3000 CA Rotterdam, the Netherlands
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Bettencourt N, Wilson CJ, Johnson PJ, D'Souza F. A Rebalancing of Financial Valuations and Expectations Moving Forward in the Telehealth Sector as the United States Moves Toward a Post-COVID-19 Reality. J Med Internet Res 2023; 25:e35857. [PMID: 37523216 PMCID: PMC10425816 DOI: 10.2196/35857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/29/2022] [Accepted: 06/16/2023] [Indexed: 08/01/2023] Open
Abstract
The telehealth sector of health care delivery experienced significant growth at the start of the pandemic as web-based care quickly became essential for the ongoing safety of patients and health care providers, such as clinicians and other health care professionals. After vaccines were introduced, however, telehealth companies lost value as the need for web-based care appeared to lessen. Presently, both existing telehealth companies and new entrants to the space are seeking ways to innovate, gain investor and customer buy-in, and overcome competitors. New companies are hoping to be seen not as pandemic-era substitutes, but instead as reinforcements to in-person care, valuable in their own right thanks to the convenience and technological advancements they bring. This struggle to reframe the value proposition, or perceived benefit, of telehealth is reflected in fluctuating stock prices and dropping valuations. This viewpoint summarizes the market volatility seen in the telehealth sector since the start of the COVID-19 pandemic and suggests potential opportunities for growth in the space. This is accomplished through a qualitative secondary research approach, leveraging contemporary sources, financial references such as Yahoo! Finance, and peer-reviewed literature to support predictions for the future market. We found that, in 2020, the size of the US telehealth market rose to US $17.9 billion and is estimated to reach US $140.7 billion by 2030. Additionally, digital health venture funding nearly doubled in 2020 over the prior 2 years with total funding rising to US $14.1 billion. However, these factors produced an oversaturated market in which the volume of supply was higher than demand, resulting in a sharp drop in valuations for some as vaccination rates climbed in 2021. In the face of this rebalancing, or return to normal following excessively high or unsustainable valuations, we suggest a possible path forward for telehealth companies in the postpandemic era. Suppliers' current role in the telehealth space-whether health care industry incumbents, that is, traditional health care delivery systems and companies, or "telehealth-first" challengers-are especially relevant to the specific growth strategies they should pursue. Furthermore, consideration of the areas of medicine and characteristics that best lend themselves to web-based care may lead to a greater chance for long-term success in a postpandemic health care delivery system. In the future, we believe investors should expect a bullish market, that is, one characterized by growing share prices. Success is likely to occur in part through changing the actual models of care, as opposed to moving traditional care to a web-based format. The oversaturated market will likely condense into select established telehealth giants who were able to adapt to the changing landscape. While investors may be reasonably hesitant regarding individual telehealth companies, the industry can expect slowed but continued growth.
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Tsagkaris C, Trygonis N, Spyrou V, Koulouris A. Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities. Cancers (Basel) 2023; 15:3700. [PMID: 37509361 PMCID: PMC10378403 DOI: 10.3390/cancers15143700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has created a challenging environment for sarcoma patients. Most oncology societies published guidelines or recommendations prioritizing sarcoma patients and established telehealth as an efficient method of approaching them. The aim of this review is the assessment of current evidence regarding the utilization of telemedicine in diagnosis, treatment modalities, telerehabilitation and satisfaction among sarcoma patients and healthcare providers (HP). METHODS This systematic review was carried out using the databases PubMed and Ovid MEDLINE according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). RESULTS The application of telemedicine to the management of sarcoma has yielded improved clinical and psychological outcomes. Specifically, significant progress has been demonstrated in the areas of tele-oncology and telerehabilitation during the last decade, and the COVID-19 outbreak has accelerated this transition toward them. Telehealth has been proven efficient in a wide spectrum of applications from consultations on physical therapy and psychological support to virtual care symptom management. Both HP and patients reported satisfaction with telehealth services at levels comparable to in-person visits. CONCLUSIONS Telehealth has already unveiled many opportunities in tailoring individualized care, and its role in the management of sarcoma patients has been established in the post-COVID-19 era, as well.
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Affiliation(s)
- Christos Tsagkaris
- European Student Think Tank, Public Health and Policy Working Group, 1058 DE Amsterdam, The Netherlands
| | - Nikolaos Trygonis
- Department of Orthopaedics, University Hospital of Heraklion, 70013 Heraklion, Greece
| | - Vasiliki Spyrou
- Post Covid Department, Theme Female Health, Karolinska University Hospital, 14157 Stockholm, Sweden
| | - Andreas Koulouris
- Department of Oncology-Pathology, Karolinska Institute, 17176 Stockholm, Sweden
- Thoracic Oncology Center, Theme Cancer, Karolinska University Hospital, 17177 Stockholm, Sweden
- Faculty of Medicine, University of Crete, 70013 Heraklion, Greece
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Sinha Gregory N, Shukla AP, Noel JJ, Alonso LC, Moxley J, Crawford AJ, Martin P, Kumar S, Leonard JP, Czaja SJ. The feasibility, acceptability, and usability of telehealth visits. Front Med (Lausanne) 2023; 10:1198096. [PMID: 37538312 PMCID: PMC10394377 DOI: 10.3389/fmed.2023.1198096] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/22/2023] [Indexed: 08/05/2023] Open
Abstract
Background Telemedicine is now common practice for many fields of medicine, but questions remain as to whether telemedicine will continue as an important patient care modality once COVID-19 becomes endemic. We explored provider and patients' perspectives on telemedicine implementation. Methods Physicians from three specialties within the Department of Medicine of a single institution were electronically surveyed regarding their perceptions of satisfaction, benefits, and challenges of video visits, as well as the quality of interactions with patients. Patients were surveyed via telephone by the Survey Research Group at Cornell about participation in video visits, challenges encountered, perceived benefits, preferences for care, and overall satisfaction. Results Providers reported an overwhelmingly positive experience with video visits, with the vast majority agreeing that they were comfortable with the modality (98%) and that it was easy to interact with patients (92%). Most providers (72%) wanted to have more telemedicine encounters in the future. Key factors interfering with successful telemedicine encounters were technical challenges and insufficient technical support. Overall, patients also perceived video visits very positively regarding ease of communication and care received and had few privacy concerns. Some (10%-15%) patients expressed interest in receiving more technical support and training. There was a gradient of satisfaction with telemedicine across specialties with patients receiving weight management reporting more favorable responses while patients with lymphoma expressed more mixed responses. Conclusion Both providers and patients found telemedicine to be an acceptable and useful modality to provide or receive medical care. The principal barrier to successful encounters was technical challenges.
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Affiliation(s)
- Naina Sinha Gregory
- Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine, New York City, NY, United States
| | - Alpana P. Shukla
- Division of Endocrinology, Diabetes and Metabolism, Comprehensive Weight Control Center, Weill Cornell Medicine, New York City, NY, United States
| | - Jahi J. Noel
- College of Agriculture and Life Science, Cornell University, Ithaca, NY, United States
| | - Laura C. Alonso
- Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine, New York City, NY, United States
| | - Jerad Moxley
- Division of Geriatric and Palliative Medicine, Weill Cornell Medicine, New York City, NY, United States
| | - Andrew J. Crawford
- Division of Endocrinology, Diabetes and Metabolism, Weill Cornell Medicine, New York City, NY, United States
| | - Peter Martin
- Division of Hematology/Oncology, Weill Cornell Medicine, New York City, NY, United States
| | - Sonal Kumar
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York City, NY, United States
| | - John P. Leonard
- Division of Hematology/Oncology, Weill Cornell Medicine, New York City, NY, United States
| | - Sara J. Czaja
- Division of Geriatric and Palliative Medicine, Weill Cornell Medicine, New York City, NY, United States
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Al Mutair A, Saha C, Alhuqbani W, Alhuqbani MN, AlQahtani MN, Abogosh AK, Alsedrah AM, Alhindi AH, Alfehaid RH, Al-Omari A. Utilization of Telemedicine during COVID-19 in Saudi Arabia: A Multicenter Study. Cureus 2023; 15:e41541. [PMID: 37554605 PMCID: PMC10404792 DOI: 10.7759/cureus.41541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The outbreak of the novel Coronavirus disease 2019 (COVID-19) has influenced all aspects of life and significantly impacted healthcare services. It has collectively necessitated the use of telemedicine in providing healthcare. Through this study, we aim to report the statistics on telemedicine utilization and satisfaction across the Kingdom of Saudi Arabia during COVID-19. METHODS This is a cross-sectional study to report the utilization and patient satisfaction with telemedicine services across Saudi Arabia. The data was collected retrospectively from March 2020 to July 2020 on 22,620 patients who used telemedicine services for consultations, medicine refills, and home healthcare visits during COVID-19. RESULTS The patients received a quick response to their calls within a mean (± SD) waiting time of 2.54 (± 6.8) minutes corresponding to a median (IQR) of 0 (0-1) minutes. Home healthcare services were presented within a median (IQR) time of 20.16 (4.64 - 42.28) hours, and patients received medication at home with a median (IQR) time of 18.8 (12.15 - 36.1) hours. Conversations over the phone varied for a median (IQR) time of 5 (3-7) minutes. The highest number of telemedicine calls were for family medicine consultations, i.e., 6729 (29.7%), and the lowest was for infectious diseases 04 (0.1%), followed by cardiology consultations, i.e., 635 (2.8%). A total of 13,154 (58.15) rated their overall satisfaction, of which 11,684 (88.82%) found telemedicine services satisfactory. CONCLUSION The utilization of telemedicine across Saudi Arabia results have shown telemedicine to be a satisfactory service for convenient and safe communication between patients and their healthcare providers. It can thus be established as a smart and indissoluble service across the kingdom. However, there is a need to raise awareness of insurance coverage for such services to make them more feasible and accessible to the public.
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Affiliation(s)
| | - Chandni Saha
- Research Center, Almoosa Health Group, Al Ahsa, SAU
| | - Waad Alhuqbani
- Research, King Faisal Specialist Hospital and Research Centre, Riyadh, SAU
| | | | | | - Ahmad K Abogosh
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, SAU
| | | | | | - Reema H Alfehaid
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, SAU
| | - Awad Al-Omari
- Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, SAU
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Nazareth Aguiar P, Stival M, Magalhães Filho MAF, Del Giglio A. Physical Examination in Medical Oncology Guiding the Development of a Protocol for Teleoncology Care in a Public Health Care Oncology Service. JCO Clin Cancer Inform 2023; 7:e2200152. [PMID: 37186889 DOI: 10.1200/cci.22.00152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
PURPOSE We aimed to define clinical variables that could predict changes in physical examination (PE) findings and consequently lead to significant differences in clinical management. This knowledge is important because of the growing popularity of teleoncology consultations, in which there is no possibility of PE, aside from inspection. METHODS This prospective study was conducted in two public hospitals in Brazil. Clinical variables and findings of PE, as well as the management plan determined at the end of the medical appointment, were systematically recorded. RESULTS A total of 368 in-person clinical evaluations of patients with cancer were included. PE was normal or had alterations already seen in previous consultations in 87% of the cases. Among patients with new changes in PE (n = 49), cancer treatment was maintained in 59%, complementary examinations and specialist appointments were requested in 31%, and oncological therapy was modified directly after PE in 10%. Of the total 368 visits, only 12 (3%) had a change in oncological management, five directly after PE abnormalities and 7 after complementary assessment. The presence of symptoms and reasons for consultation other than follow-up showed a positive association with alterations in PE and consequent changes in clinical management by univariate and multivariate analysis (P < .05). CONCLUSION Considering changes in clinical management, PE on every encounter for medical oncology surveillance visits may not be necessary. We envision that teleoncology will be a safe modality in most cases, given the large percentage of asymptomatic patients with no changes in PE during face-to-face care. However, for patients with advanced disease and symptoms, however, we suggest priority for in-person care.
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Affiliation(s)
- Pedro Nazareth Aguiar
- Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, SP, Brazil
- Grupo Oncoclínicas, São Paulo, SP, Brazil
| | - Mirella Stival
- Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | | | - Auro Del Giglio
- Centro Universitário Saúde ABC, Faculdade de Medicina do ABC, Santo André, SP, Brazil
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13
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Hung M, Ocampo M, Raymond B, Mohajeri A, Lipsky MS. Telemedicine among Adults Living in America during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095680. [PMID: 37174198 PMCID: PMC10178773 DOI: 10.3390/ijerph20095680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
Background and Objectives Telemedicine can expand healthcare access to populations, but relying on technology risks a digital divide. Therefore, it is important to understand who utilizes telemedicine. This study explores telemedicine usage across socio-demographic groups in the United States during COVID-19. Methods Data came from the Household Pulse Survey (HPS) between 14 April 2021, to 11 April 2022. HPS is a rapid online response survey that assesses household experiences during COVID-19. We calculated descriptive statistics and used cross-correlation to test each pair of the time series curves. Results High school graduates used the least telemedicine (20.58%), while those with some college (23.29%) or college graduates (22.61%) had similar levels, and those with less than a high school education fluctuated over time. Black people had higher levels of use (26.31%) than Asians (22.01%). Individuals with disabilities (35.40%) used telemedicine more than individuals without disabilities (20.21%). Individuals 80 years or over (27.63%) used telemedicine more than individuals 18 to 29 years old (18.44%). Cross-correlations for the time series pairs across demographics revealed significant differences in telemedicine use for all demographic groups over time. Conclusions Overall, elderly, Black people, individuals with some college, and persons with disabilities report higher levels of telemedicine use. Telemedicine may improve healthcare access post-pandemic, but more research is needed to understand factors that drive differences among groups.
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Affiliation(s)
- Man Hung
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- Division of Public Health, University of Utah, Salt Lake City, UT 84108, USA
- Department of Educational Psychology, University of Utah, Salt Lake City, UT 84109, USA
- College of Social Work, University of Utah, Salt Lake City, UT 84112, USA
- Department of Veterans Affairs Medical Center, Salt Lake City, UT 84148, USA
| | - Monica Ocampo
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Benjamin Raymond
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Amir Mohajeri
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
| | - Martin S Lipsky
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, UT 84095, USA
- Institute on Aging, Portland State University, Portland, OR 97201, USA
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14
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Morton C, Sullivan R, Sarker D, Posner J, Spicer J. Revitalising cancer trials post-pandemic: time for reform. Br J Cancer 2023; 128:1409-1414. [PMID: 36959378 PMCID: PMC10035974 DOI: 10.1038/s41416-023-02224-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/06/2023] [Accepted: 02/28/2023] [Indexed: 03/25/2023] Open
Abstract
The COVID-19 pandemic posed significant risk to the health of cancer patients, compromised standard cancer care and interrupted clinical cancer trials, prompting dramatic streamlining of services. From this health crisis has emerged the opportunity to carry forward an unexpected legacy of positive reforms to clinical cancer research, where conventionally convoluted approvals processes, inefficient trial design, procedures and data gathering could benefit from the lessons in rationalisation learned during the pandemic.
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Affiliation(s)
- Cienne Morton
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK.
| | | | - Debashis Sarker
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - John Posner
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
| | - James Spicer
- Department of Medical Oncology, Guy's & St Thomas NHS Foundation Trust, London, UK
- School of Cancer & Pharmaceutical Sciences, King's College London, London, UK
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15
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Suleman A, Vijenthira A, Liu ZA, Truong T, Berlin A, Prica A, Rodin D. Virtual Care During the COVID-19 Pandemic for Patients With Hematologic Malignancies: A Single-Institution Experience. JCO Oncol Pract 2023; 19:e672-e682. [PMID: 36821811 DOI: 10.1200/op.22.00690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
PURPOSE The use of virtual care rapidly increased during the COVID-19 pandemic and has persisted as a routine method of care delivery. Much of the literature on virtual care in oncology has focused on solid tumors, and little is known about its application in malignant hematology. METHODS We performed a retrospective review of patients with hematologic malignancies at Princess Margaret Cancer Centre from October 2019 to March 2021 to determine the use of virtual care during this period, cost-savings associated with virtual visits, and patient satisfaction. Patient satisfaction was assessed using the Your Voice Matters survey, a provincially administered survey to evaluate patient experience. RESULTS Overall, 12.1% (1,122/9,295) of patients had a virtual visit during the study period (0% from October 2019 to February 2020, 36% from March to August 2020, and 30% from September 2020 to March 2021), of which 36% were in the lymphoma clinic and 46% were in the myeloma clinic. The mean two-way opportunity cost for an in-person visit was $168.00 CAD per person with public transit, and $120.40 CAD per person driving. Responses to the Your Voice Matters survey indicated that patients with a virtual visit reported that physical symptoms were discussed appropriately (mean 4.73/5), and were more likely to ask for a follow-up virtual visit compared with patients with in-person visits (mean 4.50/5 v 3.02/5, respectively; P < .01). CONCLUSION These findings suggest that virtual care may be a feasible and well-received tool for delivering care to a substantial proportion of patients with hematologic malignancies, while enabling substantial cost-savings to patients.
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Affiliation(s)
- Adam Suleman
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Abi Vijenthira
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Zhihui Amy Liu
- Cancer Digital Intelligence Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Tran Truong
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Alejandro Berlin
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada.,Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
| | - Anca Prica
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Canada
| | - Danielle Rodin
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Canada
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16
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Linjawi M, Shakoor H, Hilary S, Ali HI, Al-Dhaheri AS, Ismail LC, Apostolopoulos V, Stojanovska L. Cancer Patients during COVID-19 Pandemic: A Mini-Review. Healthcare (Basel) 2023; 11:healthcare11020248. [PMID: 36673615 PMCID: PMC9859465 DOI: 10.3390/healthcare11020248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/10/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
Since its emergence, coronavirus disease 2019 (COVID-19) has affected the entire world and all commerce and industries, including healthcare systems. COVID-19 adversely affects cancer patients because they are immunocompromised. Increased COVID-19 infection and shortage of medical supplies, beds and healthcare workers in hospitals affect cancer care. This paper includes a description of the existing research that shows the impact of COVID-19 on the management of cancer patients. Aged people with various chronic conditions such as cancer and comorbidities face more challenges as they have a greater risk of disease severity. COVID-19 has affected care delivery, including patient management, and has been responsible for increased mortality among cancer patients. Cancer patients with severe symptoms require regular therapies and treatment; therefore, they have a higher risk of exposure. Due to the risk of transmission, various steps were taken to combat this disease; however, they have affected the existing operational efficiency. Herein, we present the changing priorities during COVID-19, which also affected cancer care, including delayed diagnosis, treatment, and surgeries.
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Affiliation(s)
- Maryam Linjawi
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Hira Shakoor
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Serene Hilary
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Correspondence: (S.H.); (L.S.)
| | - Habiba I. Ali
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Ayesha S. Al-Dhaheri
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
| | - Leila Cheikh Ismail
- Department of Clinical Nutrition and Dietetics, College of Health Sciences, Research Institute of Medical and Health Sciences (RIMHS), University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates
- Nuffield Department of Women’s and Reproductive Health, University of Oxford, Oxford, OX3 9DU, UK
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
| | - Lily Stojanovska
- Department of Nutrition and Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain P.O. Box 15551, United Arab Emirates
- Institute for Health and Sport, Victoria University, Melbourne, VIC 3030, Australia
- Correspondence: (S.H.); (L.S.)
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17
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Geifman N, Armes J, Whetton AD. Identifying developments over a decade in the digital health and telemedicine landscape in the UK using quantitative text mining. Front Digit Health 2023; 5:1092008. [PMID: 37139488 PMCID: PMC10149860 DOI: 10.3389/fdgth.2023.1092008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/24/2023] [Indexed: 05/05/2023] Open
Abstract
The use of technologies that provide objective, digital data to clinicians, carers, and service users to improve care and outcomes comes under the unifying term Digital Health. This field, which includes the use of high-tech health devices, telemedicine and health analytics has, in recent years, seen significant growth in the United Kingdom and worldwide. It is clearly acknowledged by multiple stakeholders that digital health innovations are necessary for the future of improved and more economic healthcare service delivery. Here we consider digital health-related research and applications by using an informatics tool to objectively survey the field. We have used a quantitative text-mining technique, applied to published works in the field of digital health, to capture and analyse key approaches taken and the diseases areas where these have been applied. Key areas of research and application are shown to be cardiovascular, stroke, and hypertension; although the range seen is wide. We consider advances in digital health and telemedicine in light of the COVID-19 pandemic.
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Affiliation(s)
- Nophar Geifman
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Correspondence: Nophar Geifman
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Anthony D. Whetton
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- Veterinary Health Innovation Engine, School of Veterinary Medicine, University of Surrey, Guildford, United Kingdom
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18
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Di Giorgio A, Gerardi C, Abatini C, Melotti G, Bonavina L, Torri V, Santullo F, Garattini S, De Luca M, Rulli E, Rulli E, Pacelli F. Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery for gastric carcinoma at high risk of peritoneal carcinomatosis: short and long-term outcomes (GOETH STUDY)-a collaborative randomized controlled trial by ACOI, FONDAZIONE AIOM, SIC, SICE, and SICO. Trials 2022; 23:969. [PMID: 36457115 PMCID: PMC9714394 DOI: 10.1186/s13063-022-06880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 11/02/2022] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION At the time of diagnosis, 15-20% of gastric carcinomas are in stage T4 or T4b. Furthermore, 5-20% of patients undergoing potentially curative surgery suffer from synchronous or metachronous peritoneal metastases. To date, neither surgery nor systemic chemotherapy successfully controls peritoneal dissemination, offering a limited impact on survival. Peritoneal metastases are in fact responsible for death in around 60% of gastric cancer patients. Several Eastern studies in the past have focused on hyperthermic intraperitoneal chemotherapy (HIPEC) as a prophylactic measure in patients with serosal extension, nodal involvement, and positive peritoneal fluid cytology. Therefore, a new multimodal therapeutic strategy based on aggressive surgery plus new locoregional treatment may prolong survival in this particular clinical scenario. METHODS This study compares the efficacy of prophylactic surgery (radical gastric resection, appendectomy, resection of the round ligament of the liver, and bilateral adnexectomy) plus hybrid CO2 HIPEC system versus standard surgery in patients with T3-T4 N0-N + gastric adenocarcinoma. Patients will be randomly assigned (1:1 ratio) to the experimental arm or standard surgery. The primary endpoint is to establish the difference in disease-free survival between the groups. The secondary objective is to compare the safety and tolerability of prophylactic surgery plus HIPEC CO2 versus standard surgery. DISCUSSION Considering the poor prognosis of patients with peritoneal dissemination from gastric cancer, a prophylactic strategy to prevent peritoneal metastases may be beneficial. In patients with gastric cancer at high risk of peritoneal carcinomatosis, we propose aggressive surgical treatment with radical gastrectomy, removal of organs at risk of harbouring tumour cells, and HIPEC. TRIAL REGISTRATION ClinicalTrials.gov NCT03917173. Registered on 16 April 2019. PROTOCOL VERSION v1, March 27, 2019. Protocol number: IRFMN-GCC-7813. EudraCT number: 2019-001478-27.
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Affiliation(s)
- A. Di Giorgio
- grid.411075.60000 0004 1760 4193Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - C. Gerardi
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - C. Abatini
- grid.411075.60000 0004 1760 4193Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - G. Melotti
- Associazione Chirurghi Ospedalieri Italiani, ACOI, Rome, Italy
| | - L. Bonavina
- grid.419557.b0000 0004 1766 7370Division of General and Foregut Surgery, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato and University of Milan, Milan, Italy
| | - V. Torri
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - F. Santullo
- grid.411075.60000 0004 1760 4193Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
| | - S. Garattini
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - M. De Luca
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - Erica Rulli
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - Eliana Rulli
- grid.4527.40000000106678902Istituto Di Ricerche Farmacologiche “Mario Negri” IRCCS, Milan, Italy
| | - F. Pacelli
- grid.411075.60000 0004 1760 4193Operational Unit of Peritoneum and Retroperitoneum Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8, 00168 Rome, Italy
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19
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Teleoncology: A Solution for Everyone? A Single-Center Experience with Telemedicine during the Coronavirus Disease 2019 (COVID-19) Pandemic. Curr Oncol 2022; 29:8565-8578. [PMID: 36421328 PMCID: PMC9689494 DOI: 10.3390/curroncol29110675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/13/2022] Open
Abstract
Since the beginning of the COVID-19 pandemic, the use of telehealth was rapidly implemented without previous evidence. The ONCOTELEMD study aimed to evaluate the opinion of patients attended via telemedicine during this period and to study factors that condition patient preferences on its use. Included patients had a confirmed cancer diagnosis and were contacted by telephone between 13 March and 30 April 2020, in the Medical Oncology Service of Hospital Parc Taulí, Sabadell. A 12-question survey was presented to them between 4 February and 19 April 2021. Statistical analysis was carried out using chi-square and multivariable logistic regression tests. Six hundred forty-six patients were included; 487 responded to the survey. The median age was 68 years (27-90), 55.2% were female. Most patients had a surveillance visit (65.3%) and were diagnosed with colorectal or breast cancer (43% and 26.5%, respectively); 91.8% of patients were satisfied, and 60% would accept the use of telemedicine beyond the pandemic. Patients aged more than 50 years (OR 0.40; 95% CI, 0.19-0.81; p = 0.01) and diagnosed with breast cancer (OR 0.45; 95% CI, 0.26-0.69; p < 0.001) were less predisposed to adopt telehealth in the future. Patients agreed to be informed via telehealth of scan or lab results (62% and 84%, respectively) but not of new oral or endovenous treatments (52% and 33.5%, respectively). Additionally, 75% of patients had a medium or low-null technologic ability, and 51.3% would only use the telephone or video call to contact health professionals. However, differences were found according to age groups (p < 0.0001). In total, patients surveyed were satisfied with telemedicine and believed telehealth could have a role following the COVID-19 pandemic. Moreover, our results remark on the importance of individualizing the use of telehealth, showing relevant data on patient preferences and digital literacy.
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20
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Elhakeem I, Iqbal P, Nashwan AJ, Abubakar M, Jawad AT, AlHiyari MA, Chandra P, Osman MA, Mohamad SS, Alkhatib M, Yassin MA. Patients' experience and satisfaction using telemedicine for outpatient services in a Tertiary Cancer Center in Qatar during COVID-19: A cross-sectional study. Health Sci Rep 2022; 5:e883. [PMID: 36320657 PMCID: PMC9617592 DOI: 10.1002/hsr2.883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
Background and Aim The coronavirus-19 is an ongoing global pandemic resulting in millions of deaths worldwide. For a patient population at higher risk of infection, telemedicine is a promising means of providing safe and alternative care routes while minimizing their risk of exposure. This study gives insight into patients' experiences and satisfaction with telemedicine during this pandemic. Methods We conducted a cross-sectional study on 297 patients (RR: 85%) at the National Center for Cancer Care and Research (NCCCR), Qatar. Data was collected through electronic medical records of the eligibe patient population, and phone calls were made whereby the physician read a standard introductory script followed by a survey questionnaire. We focused on patients' experience with telemedicine services amid the pandemic. This was done using a six-point Likert scoring system of seven questions that were scaled from 1 to 6. Results More than 80% of patients somewhat to strongly agreed that telemedicine met their healthcare needs, improved their confidence in their healthcare system, and were generally satisfied with the quality of care provided. Nearly all patients (90%) understood their physicians' recommendations over the phone. In addition, more than half of the patients (89%) felt they could freely communicate their concerns. Patients also showed an inclination towards face-to-face consultations at 68%; however, 90% were willing to participate in future teleconsultations. Conclusion Our study indicates an overall positive experience among patients towards the use of telemedicine. Telemedicine is a safe, futuristic approach toward patient care management and, thus, provides healthcare professionals a platform to implement further patient and physician education. Even though our data also showed that patients liked in-person visits to some degree, this needs to be looked into more in future studies.
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Affiliation(s)
- Israa Elhakeem
- Medical EducationHamad Medical CorporationDohaQatar,Hematology/Oncology DepartmentHamad Medical CorporationDohaQatar
| | - Phool Iqbal
- Internal Medicine DepartmentNew York Medical College/Metropolitan Hospital CenterNew YorkUSA
| | | | | | | | | | - Prem Chandra
- Academic Health SystemHamad Medical CorporationDohaQatar
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21
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Roque K, Ruiz R, Otoya-Fernandez I, Galarreta J, Vidaurre T, de Mello RA, Neciosup S, Mas L, Gómez H. The impact of telemedicine on cancer care: real-world experience from a Peruvian institute during the COVID-19 pandemic. Future Oncol 2022; 18:3501-3508. [PMID: 36367446 DOI: 10.2217/fon-2022-0239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic caused discontinuities in cancer care (CC) in most countries. Here, the authors describe the real-world impacts of implementing a contingency plan employing telemedicine for CC. Methods: A retrospective study of patients who received CC through telemedicine at the Instituto Nacional de Enfermedades Neoplasicas, Peru, from March 2020 to February 2021 was conducted. Impacts were measured by comparing the amount of CC administered during the pandemic versus the prior year. Results: A total of 16,456 telemedicine visits were carried out. An annual comparative analysis showed a gap of 23% and telemedicine accounted for 27.6% of the total CC administered during the pandemic. A high (4.50/5) level of patient satisfaction with telemedicine was reported. Conclusion: Telemedicine is an important tool to facilitate the continuity of CC.
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Affiliation(s)
- Katia Roque
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Universidad Peruana Cayetano Heredia, Lima, Peru.,Universidad Nacional Mayor de San Marcos, Lima, Peru.,Pos graduation Program in Medicine, Nine of July University (UNINOVE), Sao Paulo, Brazil
| | - Rossana Ruiz
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Universidad Cientifica del Sur, Lima, Peru
| | - Iris Otoya-Fernandez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru
| | - José Galarreta
- Department of Telemedicine, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.,Department of Breast Cancer Surgery, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru
| | - Tatiana Vidaurre
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Ramon Andrade de Mello
- Pos graduation Program in Medicine, Nine of July University (UNINOVE), Sao Paulo, Brazil.,Division of Medical Oncology, Hospital Israelita Albert Eisten, Sao Paulo, Brazil
| | - Silvia Neciosup
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Department of Medical Oncology, Oncosalud-AUNA, Lima, Peru
| | - Luis Mas
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Department of Medical Oncology, Oncosalud-AUNA, Lima, Peru
| | - Henry Gómez
- Department of Medical Oncology, Instituto Nacional de Enfermedades Neoplásicas, Angamos Este Av, 2520, Lima, Peru.,Department of Medical Oncology, Oncosalud-AUNA, Lima, Peru.,Universidad Ricardo Palma, Lima, Peru
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22
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von Weinrich P, Kong Q, Liu Y. Would you zoom with your doctor? A discrete choice experiment to identify patient preferences for video and in-clinic consultations in German primary care. J Telemed Telecare 2022:1357633X221111975. [PMID: 35915997 DOI: 10.1177/1357633x221111975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The popularity of video consultations in healthcare has accelerated during the COVID-19 pandemic. Despite increased availability and obvious benefits, many patients remain hesitant to use video consultations. This study investigates the relative importance of the consultation mode compared to other attributes in patients' appointment choices in Germany. METHODS A discrete choice experiment was conducted to examine the influence of appointment attributes on preferences for video over in-clinic consultations. A total of 350 participants were included in the analysis. RESULTS The level of continuity of care (46%) and the waiting time until the next available appointment (22%) were shown to have higher relative importance than consultation mode (18%) and other attributes. Participants with fewer data privacy concerns, higher technology proficiency, and more fear of COVID-19 tended to prefer video over in-clinic consultations. The predicted choice probability of a video over a typical in-clinic consultation and opting out increased from <1% to 40% when the video consultation was improved from the worst-case to the best-case scenario. CONCLUSION This study provides insight into the effect of the consultation mode on appointment choice at a time when telemedicine gains momentum. The results suggest that participants preferred in-clinic over video consultations. Policymakers and service providers should focus on increasing the level of continuity of care and decreasing the time until the next available appointment to prompt the adoption of video consultations. Although participants preferred to talk to their physician in person over consulting via video per se, the demand for video consultations can be increased significantly by improving the other appointment attributes of video consultations such as the level of continuity of care.
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Affiliation(s)
- Philipp von Weinrich
- Rotterdam School of Management, 6984Erasmus University Rotterdam, The Netherlands
| | - Qingxia Kong
- Rotterdam School of Management, 6984Erasmus University Rotterdam, The Netherlands
| | - Yun Liu
- Erasmus School of Health Policy and Management, 84857Erasmus University Rotterdam, The Netherlands
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Laskar SG, Sinha S, Krishnatry R, Grau C, Mehta M, Agarwal JP. Access to Radiation Therapy: From Local to Global and Equality to Equity. JCO Glob Oncol 2022; 8:e2100358. [PMID: 35960905 PMCID: PMC9470145 DOI: 10.1200/go.21.00358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The discipline of radiation oncology is the most resource-intensive component of comprehensive cancer care because of significant initial investments required for machines, the requirement of dedicated construction, a multifaceted workforce, and recurring maintenance costs. This review focuses on the challenges associated with accessible and affordable radiation therapy (RT) across the globe and the possible solutions to improve the current scenario. Most common cancers globally, including breast, prostate, head and neck, and cervical cancers, have a RT utilization rate of > 50%. The estimated annual incidence of cancer is 19,292,789 for 2020, with > 70% occurring in low-income countries and low-middle–income countries. There are approximately 14,000 teletherapy machines globally. However, the distribution of these machines is distinctly nonuniform, with low-income countries and low-middle–income countries having access to < 10% of the global teletherapy machines. The Directory of Radiotherapy Centres enlists 3,318 brachytherapy facilities. Most countries with a high incidence of cervical cancer have a deficit in brachytherapy facilities, although formal estimates for the same are not available. The deficit in simulators, radiation oncologists, and medical physicists is even more challenging to quantify; however, the inequitable distribution is indisputable. Measures to ensure equitable access to RT include identifying problems specific to region/country, adopting indigenous technology, encouraging public-private partnership, relaxing custom duties on RT equipment, global/cross-country collaboration, and quality human resources training. Innovative research focusing on the most prevalent cancers aiming to make RT utilization more cost-effective while maintaining efficacy will further bridge the gap. Improving global access to Radiotherapy: The current scenario and the road ahead
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Affiliation(s)
- Sarbani Ghosh Laskar
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Shwetabh Sinha
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Rahul Krishnatry
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
| | - Cai Grau
- Department of Radiation Oncology and Danish Center for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark
| | - Minesh Mehta
- Department of Radiation Oncology, Miami Cancer Institute, Miami, FL
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Homi Bhabha National Institute, Tata Memorial Centre, Mumbai, India
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Pacelli F, Gerardi C, Rulli E, Abatini C, Rotolo S, Garattini S, Melotti G, Torri V, Galli F, Rulli E, Di Giorgio A. Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery in colorectal carcinoma at high risk of peritoneal carcinomatosis: short-term and long-term outcomes from the CHECK study - protocol for a randomised, multicentre, phase 3 trial. BMJ Open 2022; 12:e051324. [PMID: 35914916 PMCID: PMC9345052 DOI: 10.1136/bmjopen-2021-051324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Up to one-fifth of patients with colorectal cancer will develop peritoneal metastases, frequently without other districts' involvement. Despite the recent unsuccesses of hyperthermic intraperitoneal chemotherapy (HIPEC) for colorectal cancer peritoneal metastases treatment, the rationale in the prophylactic setting remains strong. Several clinical and pharmacokinetic data suggest that the efficacy of intraperitoneal chemotherapy is highest when the disease is microscopic. However, robust evidence demonstrating whether the addition of HIPEC for high-risk colorectal cancers offers better control of local recurrence is lacking. METHODS AND ANALYSIS This is a multicentre randomised phase 3 trial comparing prophylactic surgery plus HIPEC CO2 with mitomycin, over standard surgical excision in patients with colorectal cancer at high risk of peritoneal carcinomatosis; 388 patients will be included in this study. The primary objective is to compare the efficacy of prophylactic surgery (radical colorectal resection, omentectomy, appendectomy, round ligament of the liver resection and bilateral adnexectomy) plus HIPEC CO2 with mitomycin and standard surgery in terms of local recurrence-free survival. The main secondary endpoints are disease-free survival (DFS), overall survival (OS) and safety. The primary endpoint will be described with a cumulative incidence function and will be analysed with Grey test to take account of the competing risks. DFS and OS will be described with the Kaplan-Meier method. ETHICS AND DISSEMINATION This trial has been evaluated by the Italian Medicines Agency, local ethics committees and will be submitted to the Ministry of Health to notify the start of the trial according to the regulation of trials on devices with CE mark/certification.The results will be submitted for presentation at academic meetings and for publication in a peer-reviewed journal, whatever the findings. TRIAL REGISTRATION NUMBER NCT03914820.
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Affiliation(s)
- Fabio Pacelli
- Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Chiara Gerardi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Eliana Rulli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Carlo Abatini
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Stefano Rotolo
- Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
- Dipartimento di Discipline Chirurgiche, Oncologiche e Stomatologiche (Di.Chir.On.S.), Università degli Studi di Palermo, Palermo, Italy
| | - Silvio Garattini
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | | | - Valter Torri
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Fabio Galli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Erica Rulli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Andrea Di Giorgio
- Chirurgia del Peritoneo e del Retroperitoneo, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
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Guarino M, Cossiga V, Capasso M, Mazzarelli C, Pelizzaro F, Sacco R, Russo FP, Vitale A, Trevisani F, Cabibbo G. Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma. J Clin Med 2022; 11:jcm11154475. [PMID: 35956091 PMCID: PMC9369221 DOI: 10.3390/jcm11154475] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 02/07/2023] Open
Abstract
Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.
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Affiliation(s)
- Maria Guarino
- Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (V.C.); (M.C.)
- Correspondence:
| | - Valentina Cossiga
- Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (V.C.); (M.C.)
| | - Mario Capasso
- Gastroenterology and Hepatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (V.C.); (M.C.)
| | - Chiara Mazzarelli
- Hepatology and Gastroenterology Unit, ASST Grande Ospedale Metropolitano Niguarda, 20162 Milan, Italy;
| | - Filippo Pelizzaro
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy; (F.P.); (F.P.R.)
- Gastroenterology Unit, Azienda Ospedale-Università di Padova, 35128 Padova, Italy
| | - Rodolfo Sacco
- Gastroenterology and Endoscopy Unit, Policlinico Riuniti, 71122 Foggia, Italy;
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy; (F.P.); (F.P.R.)
- Gastroenterology Unit, Azienda Ospedale-Università di Padova, 35128 Padova, Italy
| | - Alessandro Vitale
- Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, 35122 Padova, Italy;
| | - Franco Trevisani
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
- Unit of Semeiotics, Liver and Alcohol-Related Diseases, Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
| | - Giuseppe Cabibbo
- Section of Gastroenterology and Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE)-University of Palermo, 90133 Palermo, Italy;
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Ganjali R, Jajroudi M, Kheirdoust A, Darroudi A, Alnattah A. Telemedicine solutions for clinical care delivery during COVID-19 pandemic: A scoping review. Front Public Health 2022; 10:937207. [PMID: 35937265 PMCID: PMC9354887 DOI: 10.3389/fpubh.2022.937207] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 06/24/2022] [Indexed: 01/04/2023] Open
Abstract
Background: The unexpected emergence of coronavirus disease 2019 (COVID-19) has changed mindsets about the healthcare system and medical practice in many fields, forcing physicians to reconsider their approaches to healthcare provision. It is necessary to add new, unique, and efficient solutions to traditional methods to overcome this critical challenge. In this regard, telemedicine offers a solution to this problem. Remote medical activities could diminish unnecessary visits and provide prompt medical services in a timely manner. Objective This scoping review aimed to provide a map of the existing evidence on the use of telemedicine during the COVID-19 pandemic by focusing on delineation functions and technologies, analyzing settings, and identifying related outcomes. Methods This review was conducted following the Arksey and O'Malley framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed and Scopus databases were systematically searched based on specific eligibility criteria. The English publications included in this study focused on telemedicine systems implemented during the COVID-19 pandemic to provide clinical care services. Two independent reviewers screened the articles based on predefined inclusion and exclusion criteria. The relevant features of telemedicine systems were summarized and presented into the following four domains and their subcategories, including functionality, technology, context, and outcomes. Results Out of a total of 1,602 retrieved papers, 66 studies met the inclusion criteria. The most common function implemented was counseling, and telemedicine was used for diagnosis in seven studies. In addition, in 12 studies, tele-monitoring of patients was performed by phone, designed platforms, social media, Bluetooth, and video calls. Telemedicine systems were predominantly implemented synchronously (50 studies). Moreover, 10 studies used both synchronous and asynchronous technologies. Although most studies were performed in outpatient clinics or centers, three studies implemented a system for hospitalized patients, and four studies applied telemedicine for emergency care. Telemedicine was effective in improving 87.5% of health resource utilization outcomes, 85% of patient outcomes, and 100% of provider outcomes. Conclusion The benefits of using telemedicine in medical care delivery systems in pandemic conditions have been well–documented, especially for outpatient care. It could potentially improve patient, provider, and healthcare outcomes. This review suggests that telemedicine could support outpatient and emergency care in pandemic situations. However, further studies using interventional methods are required to increase the generalizability of the findings.
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Affiliation(s)
- Raheleh Ganjali
- Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- *Correspondence: Raheleh Ganjali
| | - Mahdie Jajroudi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Kheirdoust
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Darroudi
- Department of Health Information Technology, Faculty of Paramedicine, Mashhad University of Medical Science, Mashhad, Iran
| | - Ashraf Alnattah
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Fit theory: A cancer experience grounded theory emerging from semi-structured interviews with cancer patients and informal caregivers in Manitoba Canada during the COVID-19 pandemic. PLoS One 2022; 17:e0269285. [PMID: 35867713 PMCID: PMC9307189 DOI: 10.1371/journal.pone.0269285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 05/17/2022] [Indexed: 11/19/2022] Open
Abstract
Background It is not clear how changes to healthcare delivery related to the COVID-19 pandemic, including virtual care and social distancing restrictions, have impacted the experience of living with cancer. This study aimed to discover a theory capable of describing the cancer experience, how the pandemic impacted it, and for guiding predictions about how to improve it. Methods Between October 2020 and July 2021 digitally recorded semi-structured one-on-one interviews were conducted virtually with adult cancer patients and informal caregivers in Manitoba, Canada. Transcriptions and field notes from the interviews were analyzed using classic grounded theory. Results Interviews with 33 patients and 6 informal caregivers were conducted. Fit emerged as the core concept of the theory and describes the relationship between the healthcare system and the unique combination of characteristics each patient has. Good fit results in a positive experience and poor fit in a negative experience. Virtual care improves fit in clinical situations where non-verbal communication and physical examination are not important. Support from informal caregivers improves fit. Social distancing restrictions reduce the ability of informal caregivers to provide support. Conclusions The impact of fit on the cancer experience suggests that care delivery should be tailored to both the individual needs of the patient and the intention of the clinical interaction. Developing evidence-based strategies to inform the integration of virtual care into oncology practice, with aim of promoting good fit between patients and healthcare services, is an important future direction.
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Xu P, Hudnall M, Zhao S, Raja U, Parton J, Lewis D. Pandemic-Triggered Adoption of Telehealth in Underserved Communities: Descriptive Study of Pre- and Postshutdown Trends. J Med Internet Res 2022; 24:e38602. [PMID: 35786564 PMCID: PMC9290332 DOI: 10.2196/38602] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/19/2022] [Accepted: 06/03/2022] [Indexed: 12/14/2022] Open
Abstract
Background The adoption of telehealth services has been a challenge in rural communities. The reasons for the slow adoption of such technology-driven services have been attributed to social norms, health care policies, and a lack of infrastructure to support the delivery of services. However, the COVID-19 pandemic–related shutdown of in-person health care services resulted in the usage of telehealth services as a necessity rather than a choice. The pandemic also fast-tracked some needed legislation to allow medical cost reimbursement for remote examination and health care services. As services return to normalcy, it is important to examine whether the usage of telehealth services during the period of a shutdown has changed any of the trends in the acceptance of telehealth as a reliable alternative to traditional in-person health care services. Objective Our aim was to explore whether the temporary shift to telehealth services has changed the attitudes toward the usage of technology-enabled health services in rural communities. Methods We examined the Medicaid reimbursement data for the state of Alabama from March 2019 through June 2021. Selecting the telehealth service codes, we explored the adoption rates in 3 phases of the COVID-19 shutdown: prepandemic, pandemic before the rollout of mass vaccination, and pandemic after the rollout of mass vaccination. Results The trend in telemedicine claims had an opposite pattern to that in nontelemedicine claims across the 3 periods. The distribution of various characteristics of patients who used telemedicine (age group, gender, race, level of rurality, and service provider type) was different across the 3 periods. Claims related to behavior and mental health had the highest rates of telemedicine usage after the onset of the pandemic. The rate of telemedicine usage remained at a high level after the rollout of mass vaccination. Conclusions The current trends indicate that adoption of telehealth services is likely to increase postpandemic and that the consumers (patients), service providers, health care establishments, insurance companies, and state and local policies have changed their attitudes toward telehealth. An increase in the use of telehealth could help local and federal governments address the shortage of health care facilities and service providers in underserved communities, and patients can get the much-needed care in a timely and effective manner.
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Affiliation(s)
- Pei Xu
- Department of Systems and Technology, Auburn University, Auburn, AL, United States
| | - Matthew Hudnall
- Department of Information Systems, Statistics, and Management Science, University of Alabama, Tuscaloosa, AL, United States
| | - Sidi Zhao
- Department of Systems and Technology, Auburn University, Auburn, AL, United States
| | - Uzma Raja
- Department of Systems and Technology, Auburn University, Auburn, AL, United States
| | - Jason Parton
- Department of Information Systems, Statistics, and Management Science, University of Alabama, Tuscaloosa, AL, United States
| | - Dwight Lewis
- Department of Information Systems, Statistics, and Management Science, University of Alabama, Tuscaloosa, AL, United States
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Cancer Patients’ Experiences with Telehealth before and during the COVID-19 Pandemic in British Columbia. Curr Oncol 2022; 29:4199-4211. [PMID: 35735444 PMCID: PMC9222084 DOI: 10.3390/curroncol29060335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/26/2022] [Accepted: 06/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Patients have had their cancer care either postponed or changed to telehealth visits to reduce exposure to COVID-19. However, it is unclear how these changes may have affected their experiences. We aim to identify patient characteristics that affect telehealth experiences and evaluate their preferences for using telehealth in the future. Methods: Patients who completed the Outpatient Cancer Care (OCC) Patient Experience Survey were invited to participate. They comepleted the modified OCC Survey, which focused on telehealth during the pandemic. Linear and logistic regression analyses were used to identify patient characteristics that influenced telehealth experiences and preferences for future telehealth use. Results: Perceived ease of participation in telehealth is a significant predictor of the change in patients’ ratings of their telehealth experience. We found that cancer patients had lower preferences for using telehealth in the future if they were older, female, or non-white; resided in an urban area; had no previous telehealth experience; had lower education; and had poorer mental health. Conclusions: To optimize cancer care and improve equitable access to high-quality telehealth care during the pandemic and beyond, clinicians and policymakers will need to consider patients’ self-reported experiences and their personal characteristics.
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Nyberg A, Rajaleid K, Demmelmaier I. The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116783. [PMID: 35682365 PMCID: PMC9180570 DOI: 10.3390/ijerph19116783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023]
Abstract
We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.
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Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
- Correspondence: ; Tel.: +46-8-708-234318
| | - Kristiina Rajaleid
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
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Pogorzelska K, Chlabicz S. Patient Satisfaction with Telemedicine during the COVID-19 Pandemic-A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106113. [PMID: 35627650 PMCID: PMC9140408 DOI: 10.3390/ijerph19106113] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 12/26/2022]
Abstract
Telemedicine is a convenient tool for providing medical care remotely. It is routinely offered as an alternative to face-to-face consultations in healthcare settings all over the world. Due to the COVID-19 pandemic and increased use of telemedicine in everyday clinical practice, the effectiveness of this modality and patient satisfaction with telemedicine is a subject of growing concern. PubMed and Google Scholar databases were searched. Papers published between January 2020 and August 2021 which met inclusion and exclusion criteria were analyzed. During the COVID-19 pandemic patients have found telemedicine a beneficial tool for consulting healthcare providers. A high level of satisfaction with telehealth was observed in each study across every medical specialty. Telemedicine is undoubtedly a convenient tool that has helped ensure continuity of medical care during the COVID-19 pandemic thanks to its considerable potential. In particular situations, telehealth may adequately replace face-to-face consultation. Regular patients’ feedback is necessary to improve the use of telemedicine in the future.
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Ascierto PA, Warner AB, Blank C, Caracò C, Demaria S, Gershenwald JE, Khushalani NI, Long GV, Luke JJ, Mehnert JM, Robert C, Rutkowski P, Tawbi HA, Osman I, Puzanov I. The "Great Debate" at Melanoma Bridge 2021, December 2nd-4th, 2021. J Transl Med 2022; 20:200. [PMID: 35538491 PMCID: PMC9087170 DOI: 10.1186/s12967-022-03406-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 04/24/2022] [Indexed: 11/10/2022] Open
Abstract
The Great Debate session at the 2021 Melanoma Bridge virtual congress (December 2-4) featured counterpoint views from experts on seven important issues in melanoma. The debates considered the use of adoptive cell therapy versus use of bispecific antibodies, mitogen-activated protein kinase (MAPK) inhibitors versus immunotherapy in the adjuvant setting, whether the use of corticosteroids for the management of side effects have an impact on outcomes, the choice of programmed death (PD)-1 combination therapy with cytotoxic T-lymphocyte-associated antigen (CTLA)-4 or lymphocyte-activation gene (LAG)-3, whether radiation is needed for brain metastases, when lymphadenectomy should be integrated into the treatment plan and then the last debate, telemedicine versus face-to-face. As with previous Bridge congresses, the debates were assigned by meeting Chairs and positions taken by experts during the debates may not have necessarily reflected their respective personal view. Audiences voted both before and after each debate.
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Affiliation(s)
- Paolo A Ascierto
- Department of Melanoma, Cancer Immunotherapy and Innovative Therapy, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", Naples, Italy.
| | | | | | - Corrado Caracò
- Division of Surgery of Melanoma and Skin Cancer, Istituto Nazionale Tumori "Fondazione Pascale" IRCCS, Naples, Italy
| | - Sandra Demaria
- Department of Radiation Oncology, Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia.,Faculty of Medicine & Health, The University of Sydney, Sydney, Australia.,Charles Perkins Centre, The University of Sydney, Sydney, Australia.,Royal North Shore Hospital, Sydney, Australia
| | - Jason J Luke
- University of Pittsburgh Medical Center, UPMC) Hillman Cancer Center, Pittsburgh, PA, USA
| | - Janice M Mehnert
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Caroline Robert
- Institut de Cancérologie Gustave Roussy Et Université Paris-Saclay, Villejuif, France
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Hussein A Tawbi
- Melanoma Medical Oncology, Investigational Cancer Therapeutics, Division of Cancer Medicine, MD Anderson Brain Metastasis Clinic, UT MD Anderson Cancer Center, Houston, TX, USA
| | - Iman Osman
- New York University Langone Medical Center, New York, NY, USA
| | - Igor Puzanov
- Department of Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
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Murphy A, Kirby A, Lawlor A, Drummond FJ, Heavin C. Mitigating the Impact of the COVID-19 Pandemic on Adult Cancer Patients through Telehealth Adoption: A Systematic Review. SENSORS 2022; 22:s22093598. [PMID: 35591287 PMCID: PMC9105995 DOI: 10.3390/s22093598] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 11/16/2022]
Abstract
During the first wave of the COVID-19 pandemic, the delivery of life-saving and life-prolonging health services for oncology care and supporting services was delayed and, in some cases, completely halted, as national health services globally shifted their attention and resources towards the pandemic response. Prior to March 2020, telehealth was starting to change access to health services. However, the onset of the global pandemic may mark a tipping point for telehealth adoption in healthcare delivery. We conducted a systematic review of literature published between January 2020 and March 2021 examining the impact of the COVID-19 pandemic on adult cancer patients. The review's inclusion criteria focused on the economic, social, health, and psychological implications of COVID-19 on cancer patients and the availability of telehealth services emerged as a key theme. The studies reviewed revealed that the introduction of new telehealth services or the expansion of existing telehealth occurred to support and enable the continuity of oncology and related services during this extraordinary period. Our analysis points to several strengths and weaknesses associated with telehealth adoption and use amongst this cohort. Evidence indicates that while telehealth is not a panacea, it can offer a "bolstering" solution during a time of disruption to patients' access to essential cancer diagnostic, treatment, and aftercare services. The innovative use of telehealth has created opportunities to reimagine the delivery of healthcare services beyond COVID-19.
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Affiliation(s)
- Aileen Murphy
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | - Ann Kirby
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | - Amy Lawlor
- Department of Economics, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland; (A.M.); (A.K.); (A.L.)
| | | | - Ciara Heavin
- Department of Business Information Systems, Cork University Business School, University College Cork, T12 CY82 Cork, Ireland
- Correspondence:
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Strowd RE, Dunbar EM, Gan HK, Kurz S, Jordan JT, Mandel JJ, Mohile NA, Nevel KS, Taylor JW, Ullrich NJ, Welch MR, Wasilewski A, Mrugala MM. Practical guidance for telemedicine use in neuro-oncology. Neurooncol Pract 2022; 9:91-104. [PMID: 35371525 PMCID: PMC8965064 DOI: 10.1093/nop/npac002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
While the COVID-19 pandemic has catalyzed the expansion of telemedicine into nearly every specialty of medicine, few articles have summarized current practices and recommendations for integrating virtual care in the practice of neuro-oncology. This article identifies current telemedicine practice, provides practical guidance for conducting telemedicine visits, and generates recommendations for integrating virtual care into neuro-oncology practice. Practical aspects of telemedicine are summarized including when to use and not use telemedicine, how to conduct a virtual visit, who to include in the virtual encounter, unique aspects of telehealth in neuro-oncology, and emerging innovations.
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Affiliation(s)
- Roy E Strowd
- Department of Neurology and Internal Medicine, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | | | - Hui K Gan
- Medical Oncology, Austin Hospital, Heidelberg, Melbourne, Australia
| | - Sylvia Kurz
- Brain and Spine Tumor Center at the Perlmutter Cancer Center, Department of Neurology, New York University Grossman School of Medicine, New York, New York, USA
| | - Justin T Jordan
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Jacob J Mandel
- Baylor College of Medicine, Department of Neurology and Neurosurgery, Houston, Texas, USA
| | - Nimish A Mohile
- Department of Neurology and Wilmot Cancer Center, University of Rochester Medical Center, Rochester, New York, USA
| | - Kathryn S Nevel
- Indiana University School of Medicine and Indiana University Health, Brain Tumor Center, Department of Neurology, Indianapolis, Indiana, USA
| | - Jennie W Taylor
- Department of Neurology and Neurological Surgery, University of California, San Francisco, California, USA
| | - Nicole J Ullrich
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mary R Welch
- Columbia University Vagelos College of Physicians and Surgeons, Herbert Irving Comprehensive Cancer Center, New York-Presbyterian Hospital, New York, New York, USA
| | | | - Maciej M Mrugala
- Mayo Clinic College of Medicine and Science, Mayo Clinic, Phoenix/Scottsdale, Arizona, USA
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Healthcare Professional Perspectives on the Use of Remote Patient-Monitoring Platforms during the COVID-19 Pandemic: A Cross-Sectional Study. J Pers Med 2022; 12:jpm12040529. [PMID: 35455645 PMCID: PMC9025393 DOI: 10.3390/jpm12040529] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion in healthcare services, protect health professionals, and help them maintain satisfactory quality and safety of care. Remote monitoring platforms (RPM) emerged as potential solutions. In this study, we evaluate, from health professionals’ perspectives, the capacity and contribution of two different digital platforms to maintain quality, safety, and patient engagement in care. A cross-sectional study was conducted using a survey in which a total of 491 health professionals participated. The results show that, in general, user perceptions of the quality and safety of care provided through the platforms were positive. The ease of access to health professionals’ services in general and shorter waiting times for patients were the two main features that were highly appreciated by most participants. However, some problems were encountered during the use of these two platforms, such as a lack of training and/or direct support for users. To improve the two platforms and maximize their use, the areas for improvement and the issues identified should be addressed as part of a collaborative process involving health professionals and patients as well as health system leaders, decision-makers, and digital platform providers.
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Ganjali R, Eslami S, Samimi T, Sargolzaei M, Firouraghi N, MohammadEbrahimi S, Khoshrounejad F, Kheirdoust A. Clinical informatics solutions in COVID-19 pandemic: Scoping literature review. INFORMATICS IN MEDICINE UNLOCKED 2022; 30:100929. [PMID: 35350124 PMCID: PMC8949656 DOI: 10.1016/j.imu.2022.100929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/06/2022] [Accepted: 03/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background The global outbreak of COVID-19 (coronavirus disease 2019) disease has highlighted the importance of disease monitoring, diagnosing, treating, and screening. Technology-based instruments could efficiently assist healthcare systems during pandemics by allowing rapid and widespread transfer of information, real-time tracking of data transfer, and virtualization of meetings and patient visits. Therefore, this study was conducted to investigate the applications of clinical informatics (CI) during the COVID-19 outbreak. Methods A comprehensive search was performed on Medline and Scopus databases in September 2020. Eligible studies were selected based on the inclusion and exclusion criteria. The extracted data from the studies reviewed were about study sample, study type, objectives, clinical informatics domain, applied method, sample size, outcomes, findings, and conclusion. The risk of bias was evaluated in the studies using appropriate instruments based on the type of each study. The selected studies were then subjected to thematic synthesis. Results In this review study, 72 out of 2716 retrieved articles met the inclusion criteria for full-text analysis. Most of the articles reviewed were done in China and the United States of America. The majority of the studies were conducted in the following CI domains: prediction models (60%), telehealth (36%), and mobile health (4%). Most of the studies in telehealth domain used synchronous methods, such as online and phone- or video-call consultations. Mobile applications were developed as self-triage, self-scheduling, and information delivery tools during the COVID-19 pandemic. The most common types of prediction models among the reviewed studies were neural network (49%), classification (42%), and linear models (4.5%). Conclusion The present study showed clinical informatics applications during COVID-19 and identified current gaps in this field. Health information technology and clinical informatics seem to be useful in assisting clinicians and managers to combat COVID-19. The most common domains in clinical informatics for research on the COVID-19 crisis were prediction models and telehealth. It is suggested that future researchers conduct scoping reviews to describe and analyze other levels of medical informatics, including bioinformatics, imaging informatics, and public health informatics.
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Affiliation(s)
- Raheleh Ganjali
- Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Eslami
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Medical Informatics, University of Amsterdam, Amsterdam, the Netherlands
| | - Tahereh Samimi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdi Sargolzaei
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Neda Firouraghi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shahab MohammadEbrahimi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farnaz Khoshrounejad
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Azam Kheirdoust
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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de Assis RT, de Morais LR, Simões de Freitas ACF, Signorini FIlho RC, Ribeiro Borges de Carvalho L, Parreira BE, Yurie Yamachi C, Braga A, Sun SY. Telemedicine in post-molar follow-up: is it a useful tool? Int J Gynecol Cancer 2022; 32:633-638. [DOI: 10.1136/ijgc-2021-003260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BackgroundTelemonitoring is an alternative to in-person appointments and overcomes geographic distance barriers.ObjectiveThe primary objective of this study was to evaluate adherence to post-molar follow-up using both WhatsApp and in-person appointments compared with standard care. The secondary objective was to evaluate the rate of completion of post-molar follow-up of complete moles, considering 6 and 3 months of duration.MethodsThis retrospective cohort study was conducted at the Gestational Trophoblastic Disease Center, São Paulo Hospital. Patients with complete or partial mole treatment between January 1, 2009 and December 31, 2018 were included in two groups: group 1 (patients from 2009 to 2013) and group 2 (from 2014 to 2018), before and after telemonitoring implementation, respectively. Complete follow-up was considered if after the first normal human chorionic gonadotropin (hCG) level (<5 mIU/mL), the patient was followed up for an additional 30 days (partial mole) or 180 days (complete mole). Loss to post-molar follow-up with positive hCG was also evaluated. Statistical analysis was performed using Pearson’s Χ2 test, 5% significance level (p=0.05), and R version 4.0.2.ResultsA total of 308 patients were included in the study, 92 of them were assessed in group 1 and 216 patients in group 2. There was no difference between the rates of complete follow-up after telemonitoring implementation (complete mole: 42/72=58.3% group 1 vs 85/163=52.1% group 2; p=0.38; partial mole: 16/20=80% group 1 vs 37/53=69.8 group 2; p=0.3), and no increase of loss to post-molar follow-up with positive hCG (8/92=8.7% group 1 vs 14/216=6.5% group 2; p=0.49). The shortening of follow-up of complete moles to 90 days increased the rate of complete post-molar follow-up (from 127/235=54.0% to 189/235=80.4%, p<0.001).ConclusionsThe association of telemonitoring with in-person appointments could have had an advantage in post-molar follow-up since it did not reduce adherence to hormonal surveillance. Shortening post-molar follow-up after complete mole to 90 days after the first normal hCG level increased the rate of complete post-molar follow-up.
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Rodríguez E, García Lumbreras S, Buscemi V, Cortí Barberá V. Experiencia del paciente oncológico durante la pandemia por el COVID-19 y su opinión sobre la telemedicina. PSICOONCOLOGIA 2022. [DOI: 10.5209/psic.80796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo: la pandemia por el COVID-19 está generando un importante impacto emocional en la población general y, en especial, en los pacientes crónicos, como los oncológicos. Además, ha supuesto cambios en la atención sanitaria. El presente estudio pretende conocer este impacto, en la población oncológica y, desde su propia experiencia, explorar sus estrategias de afrontamiento así como conocer su opinión sobre la atención sanitaria recibida. Metodología: participaron 118 pacientes pertenecientes a 5 centros hospitalarios de la provincia de Barcelona. Los datos fueron recogidos a través del cuestionario HADS y de un cuestionario ad-hoc para valorar el malestar emocional, las estrategias de afrontamiento, la percepción de riesgo de contagio, el apoyo social y los cambios ocurridos en la atención sanitaria. Resultados: el 51,4% de los participantes puntuaron alto en la escala de ansiedad y un 36% en la de depresión. La preocupación (73,7%), el miedo (72,8%), la ansiedad (56,1%) y la tristeza (56,1%) fueron las emociones más frecuentemente expresadas. El 74,1% se sintieron muy satisfechos con la atención sanitaria recibida y el 94,6% refirieron haberse sentido acompañados por su equipo sanitario. Respecto a la valoración de la telemedicina, un 40,7% manifestaron no estar a favor de esta alternativa mientras que el 33,7% consideraron que era una buena opción. Conclusiones: los pacientes oncológicos consideran que la pandemia ha afectado negativamente a su estado emocional y su calidad de vida. Conocer la opinión que tienen los pacientes sobre la telemedicina nos puede ayudar a definir más adecuadamente el uso de este tipo de asistencia.
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Berger NF, Zimmerman BS, Seidman D, Cascetta KP, Moshier E, Nezolosky M, Trlica K, Ryncarz A, Keeton C, Tiersten A. Impact of the COVID-19 Pandemic on Cancer Care and Quality of Life for Patients With Breast and Gynecologic Malignancies: A Single-Center Survey-Based Study. J Patient Exp 2022; 9:23743735221077543. [PMID: 35187223 PMCID: PMC8850998 DOI: 10.1177/23743735221077543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
This study evaluated the mental health and cancer treatment-related impact of the first wave of the COVID-19 pandemic on patients with breast and gynecologic cancers. An 18-question survey was administered in June 2020 at a New York City-based cancer center to assess the quality of life (QOL) and overall health (OH) during both the pandemic time period from March 1, 2020, through June 30, 2020, and the pre-pandemic period (prior to March 1, 2020). Survey questions were answered on a 5-point Likert scale and a 7-point EORTC QLQ-C30 QOL scale. Differences in mean QOL and OH scores were evaluated using a paired t-test. QOL and OH were significantly worsened by the pandemic, with significant increases in anxiety, depression, and mood swings.
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Affiliation(s)
- Natalie F. Berger
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Natalie F. Berger, Icahn School of Medicine at Mount Sinai, 1 Gustave Levy Place, New York, NY 10029, USA.
| | - Brittney S. Zimmerman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Danielle Seidman
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Krystal P. Cascetta
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michelle Nezolosky
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Kara Trlica
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alisa Ryncarz
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Caitlin Keeton
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Tiersten
- Hematology/Oncology Department, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Tele-neuro-oncology: Current Practices and Future Directions. Curr Oncol Rep 2022; 24:99-103. [PMID: 35059995 PMCID: PMC8773390 DOI: 10.1007/s11912-021-01176-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2021] [Indexed: 11/25/2022]
Abstract
Purpose of Review The purpose of this review is to describe the current state of telemedicine within neuro-oncology. This article will address the development of tele-neuro-oncology over time with a focus on current use and applications of telemedicine within the field. Current modalities and practical considerations for tele-neuro-oncology visits and opportunities for growth will be highlighted. Recent Findings The use of telemedicine has expanded significantly during the COVID-19 pandemic, particularly within neuro-oncology. The use of telemedicine is widely accepted by neuro-oncologic patients and providers and continues to expand in utilization and scope. The use of tele-neuro-oncology is expected to develop further with opportunities for multidisciplinary and integrated care, clinical trials, research, and education. Summary Telemedicine provides a unique, patient-centered approach to neuro-oncologic care. Telehealth will remain a valuable tool, and its use and role are expected to expand within neuro-oncology.
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Brady G, Ashforth K, Cowan-Dickie S, Dewhurst S, Harris N, Monteiro A, Sandsund C, Roe J. An evaluation of the provision of oncology rehabilitation services via telemedicine using a participatory design approach. Support Care Cancer 2022; 30:1655-1662. [PMID: 34554280 PMCID: PMC8458557 DOI: 10.1007/s00520-021-06552-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/07/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND The COVID-19 pandemic has fundamentally impacted the delivery of healthcare services globally. In line with UK government guidelines on social distancing, the use of telemedicine was implemented to facilitate the ongoing provision of cancer rehabilitation. PURPOSE We sought to evaluate and co-design telemedicine services to meet the complex needs of our patients and carers at a tertiary cancer centre. METHODS Experience-based co-design methodology was adapted to include virtual methods. Staff members (n = 12) and patients (n = 11) who had delivered or received therapies services at our UK cancer centre since March 2020 were recruited to take part in one-to-one virtual interviews. Patient interviews were video recorded, analysed and edited to a 30-min "trigger film". Patient and staff virtual events were undertaken thereafter. A joint virtual patient and staff event occurred. Staff and patients watched the trigger film and as partners, agreed areas for change and developed groups for service co-design. RESULTS Positive aspects regarding telemedicine provision were highlighted including reduced financial and time burden on patients, and increased flexibility for both staff and patients. The key concerns included digital exclusion, safety, communication and patient choice. Four co-design groups have been established to enact changes in these priority areas. CONCLUSION Using a participatory design approach, we have worked in partnership with patients and staff to ensure the safe, acceptable and effective delivery of rehabilitation services with integrated telemedicine.
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Affiliation(s)
- Grainne Brady
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK ,grid.7445.20000 0001 2113 8111Department of Surgery & Cancer, Imperial College London, London, UK
| | - Kate Ashforth
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Siobhan Cowan-Dickie
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Sarah Dewhurst
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Natalie Harris
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Alline Monteiro
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Catherine Sandsund
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK
| | - Justin Roe
- grid.5072.00000 0001 0304 893XTherapies Department, The Royal Marsden NHS Foundation Trust, London, UK ,grid.7445.20000 0001 2113 8111Department of Surgery & Cancer, Imperial College London, London, UK ,grid.417895.60000 0001 0693 2181Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust, London, UK
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Bouabida K, Malas K, Talbot A, Desrosiers MÈ, Lavoie F, Lebouché B, Taguemout M, Rafie E, Lessard D, Pomey MP. Remote Patient Monitoring Program for COVID-19 Patients Following Hospital Discharge: A Cross-Sectional Study. Front Digit Health 2021; 3:721044. [PMID: 34859244 PMCID: PMC8630581 DOI: 10.3389/fdgth.2021.721044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 09/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The COVID-19 pandemic created an urgent need to act to reduce the spread of the virus and alleviate congestion from healthcare services, protect healthcare providers, and help them maintain satisfactory quality and safety of care. Remote COVID-19 monitoring platforms emerged as potential solutions. Objective: The purpose of this study was to evaluate the capacity and contribution of two different platforms used to remotely monitor patients with COVID-19 to maintain quality, safety, and patient engagement in care, as well as their acceptability, usefulness, and user-friendliness from the user's perspective. The first platform is focused on telecare phone calls (Telecare-Covid), and the second is a telemonitoring app (CareSimple-Covid). Methods: We performed a cross-sectional study. The data were collected through a phone survey from May to August 2020. Data were analyzed using descriptive statistics and t-test analysis. Participants' responses and comments on open-ended questions were analyzed using content analysis to identify certain issues and challenges and potential avenues for improving the platforms. Results: Fifty one patients participated in the study. Eighteen participants used the CareSimple-Covid platform and 33 participants used the Telecare-Covid platform. Overall, the satisfaction rate for quality and safety of care for the two platforms was 80%. Over 88% of the users on each platform considered the platforms' services to be engaging, useful, user-friendly, and appropriate to their needs. The survey identified a few significant differences in users' perceptions of each platform: empathy toward users and the quality and safety of the care received were rated significantly higher on the CareSimple-Covid platform than on the Telecare-Covid platform. Users appreciated four aspects of these telehealth approaches: (1) the ease of access to services and the availability of care team members; (2) the user-friendliness of the platforms; (3) the continuity of care provided, and (4) the wide range of services delivered. Users identified some technical limitations and raised certain issues, such as the importance of maintaining human contact, data security, and confidentiality. Improvement suggestions include promoting access to connected devices; enhancing communications between institutions, healthcare users, and the public on confidentiality and personal data protection standards; and integrating a participatory approach to telehealth platform development and deployment efforts. Conclusion: This study provides preliminary evidence that the two remote monitoring platforms are well-received by users, with very few significant differences between them concerning users' experiences and views. This type of program could be considered for use in a post-pandemic era and for other post-hospitalization clienteles. To maximize efficiency, the areas for improvement and the issues identified should be addressed with a patient-centered approach.
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Affiliation(s)
- Khayreddine Bouabida
- University of Montreal Hospital Centre de Recherche du Centre Hospitalier Universitaire de Montréal (CRCHUM), Montreal, QC, Canada.,École de Santé publique, Département de Gestion, Université de Montréal, Montreal, QC, Canada
| | - Kathy Malas
- Excutive Office, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, QC, Canada.,Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada
| | - Annie Talbot
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Marie-Ève Desrosiers
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Frédéric Lavoie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,Network Coordination Department, CHUM, Montreal, QC, Canada
| | - Bertrand Lebouché
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Melissa Taguemout
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - Edmond Rafie
- Innovation Axis, Research Center of the CHUM, Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada
| | - David Lessard
- Canadian Institutes of Health Research Strategy for Patient-Oriented Research Mentorship Chair in Innovative Clinical Trials in Human Immunodeficiency Virus (HIV), Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Marie-Pascale Pomey
- Département de Recherche, Montreal Cancer Institute, University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada.,State-of-the-Art Technology and Methods, Montreal, QC, Canada.,Center of Excellence of Patient Partnership and the Public, Montreal, QC, Canada.,Department of Health Management, Evaluation, and Policy, School of Public Health, Université de Montréal, Montreal, QC, Canada
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Alajwari HA, Alfayez A, Alsalman D, Alanezi F, Alhodaib H, Al-Rayes S, Aljaffary A, AlThani B, AlNujaidi H, Al-Saif AK, Attar R, Aljabri D, Al-Mubarak S, Al-Juwair MM, Alrawiai S, Alakrawi Z, Alanzi TM. Knowledge and attitude of Saudi Arabian citizens towards telemedicine during the COVID-19 pandemic. Int Health 2021; 14:604-609. [PMID: 34893850 PMCID: PMC8689698 DOI: 10.1093/inthealth/ihab082] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/10/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Background The objective of this study was to investigate the knowledge and attitudes of Saudi Arabian citizens towards telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional survey was designed to carry out this study. The electronic survey, prepared using Google Forms, was distributed to 1500 randomly selected citizens of Saudi Arabia. A total of 330 participants completed and returned the questionnaire. Basic statistics were used to describe the data. Results The majority of the respondents (73.9%) were female. More than half of them (54.8%) were >35 y of age and had graduate or postgraduate degrees (65.5%). A total of 96.7% of the respondents were Saudis. Most of the participants (70.0%) were familiar with the term ‘telemedicine’ and thought that telemedicine (92.1%) could reduce transportation costs. Of the respondents, 58.8% had not seen a telemedicine system before and 67.0% indicated that they had not previously used telemedicine services. A total of 87.3% of the participants agreed or strongly agreed that telemedicine was a useful tool during the COVID-19 pandemic. Also, more than half of the participants agreed or strongly agreed that telemedicine facilitates the diagnosis of people (58.8%), increases communication (58.2%), reduces clinic visits (85.9%) and performs tasks quickly (70.3%). Also, 51.5% of the respondents disagreed or strongly disagreed that telemedicine affects patient privacy. Conclusions The outcomes indicated that most of the participants had a positive attitude towards the use of telemedicine as a response to the COVID-19 pandemic in Saudi Arabia. They believed that telemedicine saves time, labour and costs and is an effective tool to treat coronavirus patients at a safe distance. However, the government should develop programs to raise awareness in the population about the use of telemedicine for the treatment of various diseases that afflict the Saudi Arabian people. Likewise, a legal framework must be implemented to protect the privacy of patients and healthcare providers.
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Affiliation(s)
- Hadeel Abdullah Alajwari
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Asma Alfayez
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Demah Alsalman
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Fahad Alanezi
- College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hala Alhodaib
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University
| | - Saja Al-Rayes
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Afnan Aljaffary
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Bashair AlThani
- College of Business Administration, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Heba AlNujaidi
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Atheer K Al-Saif
- College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Razaz Attar
- Princess Nourah Bint Abdul Rahman University, Saudi Arabia
| | - Duaa Aljabri
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Sama'a Al-Mubarak
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Mona M Al-Juwair
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Sumaiah Alrawiai
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Zahraa Alakrawi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
| | - Turki M Alanzi
- Department of Health Information Management and Technology, College of Public Health, Imam Abdulrahman Bin Faisal University, King Faisal Road, Dammam, Saudi Arabia
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The impact of the COVID-19 pandemic on perceived access to health care and preferences for health care provision in individuals (being) treated for breast cancer. Breast Cancer Res Treat 2021; 191:553-564. [PMID: 34853988 PMCID: PMC8635319 DOI: 10.1007/s10549-021-06458-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 11/14/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE To evaluate perceived access to health care and preferences for health care provision among patients (being) treated for breast cancer during the COVID-19 pandemic. METHODS Longitudinal study within the prospective, multicenter UMBRELLA cohort of patients (being) treated for breast cancer. All cohort participants enrolled in UMBRELLA between October 2013 and November 2020 were sent a COVID-19-specific survey during the first and second wave of the COVID-19 pandemic, i.e., April 2020 and November 2020, respectively. RESULTS In total, 1106 (69.3%) and 822 (50.9%) cohort participants completed the survey in the first and second wave, respectively. The proportion of patients experiencing that their treatment or follow-up care was affected due to COVID-19 decreased from 28.4% (n = 198) in April 2020 to 14.8% (n = 103) in November 2020. Throughout the pandemic, one or more hospital consultations were postponed in 10.0% (n = 82) of all patients and changed into a teleconsultation in 23.1% (n = 190). The proportion of patients who experienced a higher threshold to contact their general practitioner due to COVID-19 decreased from 29.9% (n = 204) in the first wave to 20.8% (n = 145) in the second wave. In-person consultations remained most preferred in 35.2% (n = 289) of all patients. Nearly half of all patients (48.3%, n = 396) indicated that telehealth would be a useful alternative for in-person consultations in future. CONCLUSION Perceived access to health care has improved substantially throughout the pandemic. Digital care is well received by patients (being) treated for breast cancer.
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Yoon C, Lee J, Fong E, Lee JI. The Virtual Team Member: Remote Engagement of Medical Students in COVID-19 Care. MEDICAL SCIENCE EDUCATOR 2021; 31:1831-1838. [PMID: 34692228 PMCID: PMC8525619 DOI: 10.1007/s40670-021-01422-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
Background Medical education abruptly changed in the setting of the COVID-19 pandemic, impacting experiential learning in clinical clerkship as medical students were removed from direct patient interactions and care team participation. Re-configuring a hospital clinical rotation using virtual care platforms allowed students to re-engage in the clinical environment and actively participate in patient care. Methods During the height of the pandemic, we implemented a 4-week "virtual team member" (VTM) inpatient medicine elective for medical students in their second year and above to participate in acute patient care during the height of the COVID-19 pandemic. Tasks included providing daily updates to patients and family members along and care coordination. Faculty experts in infectious disease, mental health, ethics, and patient safety incorporated weekly didactic video talks throughout the elective. Student feedback was obtained anonymously through pre-, mid-, and post-elective questionnaires. Results A total of 26 students enrolled in the two 4-week blocks, with 85% in the 2nd year. Survey response rates for the pre, mid, and post-rotation questionnaires were 96%, 77%, 58% respectively. Of the 15 students who completed the post-survey, the majority strongly and somewhat agreed that the elective met expectations (12/15, 80%), was worthwhile (14/15, 93%) and met goals (12/15, 80%). Best parts of the elective most frequently cited by students were patient care and teamwork. Working remotely was the greatest challenge. Conclusions Designing a virtual role for students successfully allowed students to re-engage in the acute care setting and connect with patients and participate in COVID-19 care. Supplementary Information The online version contains supplementary material available at 10.1007/s40670-021-01422-8.
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Affiliation(s)
- Cecilia Yoon
- Department of Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, 53 West 23rd street, 6th floor, New York, NY USA
| | - Jihui Lee
- Department of Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, 53 West 23rd street, 6th floor, New York, NY USA
| | - Ericka Fong
- Department of Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, 53 West 23rd street, 6th floor, New York, NY USA
| | - Jennifer I. Lee
- Department of Medicine, Weill Cornell Medicine/New York Presbyterian Hospital, 53 West 23rd street, 6th floor, New York, NY USA
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Garfan S, Alamoodi AH, Zaidan BB, Al-Zobbi M, Hamid RA, Alwan JK, Ahmaro IYY, Khalid ET, Jumaah FM, Albahri OS, Zaidan AA, Albahri AS, Al-Qaysi ZT, Ahmed MA, Shuwandy ML, Salih MM, Zughoul O, Mohammed KI, Momani F. Telehealth utilization during the Covid-19 pandemic: A systematic review. Comput Biol Med 2021; 138:104878. [PMID: 34592585 PMCID: PMC8450049 DOI: 10.1016/j.compbiomed.2021.104878] [Citation(s) in RCA: 151] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 09/13/2021] [Accepted: 09/13/2021] [Indexed: 12/27/2022]
Abstract
During the coronavirus disease (COVID-19) pandemic, different technologies, including telehealth, are maximised to mitigate the risks and consequences of the disease. Telehealth has been widely utilised because of its usability and safety in providing healthcare services during the COVID-19 pandemic. However, a systematic literature review which provides extensive evidence on the impact of COVID-19 through telehealth and which covers multiple directions in a large-scale research remains lacking. This study aims to review telehealth literature comprehensively since the pandemic started. It also aims to map the research landscape into a coherent taxonomy and characterise this emerging field in terms of motivations, open challenges and recommendations. Articles related to telehealth during the COVID-19 pandemic were systematically searched in the WOS, IEEE, Science Direct, Springer and Scopus databases. The final set included (n = 86) articles discussing telehealth applications with respect to (i) control (n = 25), (ii) technology (n = 14) and (iii) medical procedure (n = 47). Since the beginning of the pandemic, telehealth has been presented in diverse cases. However, it still warrants further attention. Regardless of category, the articles focused on the challenges which hinder the maximisation of telehealth in such times and how to address them. With the rapid increase in the utilization of telehealth in different specialised hospitals and clinics, a potential framework which reflects the authors' implications of the future application and opportunities of telehealth has been established. This article improves our understanding and reveals the full potential of telehealth during these difficult times and beyond.
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Affiliation(s)
- Salem Garfan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A H Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia.
| | - B B Zaidan
- Future Technology Research Centre, National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliou, Yunlin, 64002, Taiwan, ROC
| | | | - Rula A Hamid
- College of Business Informatics, University of Information Technology and Communications (UOITC), Baghdad, Iraq
| | - Jwan K Alwan
- Biomedical Informatics College, University of Information Technology and Communications (UOITC), Baghdad, Iraq; Faculty of Computer Science and Information Technology, University of Malaya (UM), Malaysia
| | - Ibraheem Y Y Ahmaro
- Computer Science Department, College of Information Technology, Hebron University, Hebron, Palestine
| | - Eman Thabet Khalid
- Department of Computer Sciences, College of Education for Pure Sciences, University of Basrah, Basrah, Iraq
| | - F M Jumaah
- Department of Computer and Software Engineering, Polytechnique Montréal, Canada
| | - O S Albahri
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A A Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - A S Albahri
- Informatics Institute for Postgraduate Studies (IIPS), Iraqi Commission for Computers and Informatics (ICCI), Baghdad, Iraq
| | - Z T Al-Qaysi
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - M A Ahmed
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Moceheb Lazam Shuwandy
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Mahmood M Salih
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Iraq
| | - Omar Zughoul
- Computer Information System, Ahmed Bin Mohammed Military College, Al Shahaniya, Qatar
| | - K I Mohammed
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
| | - Fayiz Momani
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan Sultan Idris (UPSI), Perak, Malaysia
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Ainley E, Witwicki C, Tallett A, Graham C. Using Twitter Comments to Understand People's Experiences of UK Health Care During the COVID-19 Pandemic: Thematic and Sentiment Analysis. J Med Internet Res 2021; 23:e31101. [PMID: 34469327 PMCID: PMC8547412 DOI: 10.2196/31101] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/12/2021] [Accepted: 08/30/2021] [Indexed: 12/26/2022] Open
Abstract
Background The COVID-19 pandemic has led to changes in health service utilization patterns and a rapid rise in care being delivered remotely. However, there has been little published research examining patients’ experiences of accessing remote consultations since COVID-19. Such research is important as remote methods for delivering some care may be maintained in the future. Objective The aim of this study was to use content from Twitter to understand discourse around health and care delivery in the United Kingdom as a result of COVID-19, focusing on Twitter users’ views on and attitudes toward care being delivered remotely. Methods Tweets posted from the United Kingdom between January 2018 and October 2020 were extracted using the Twitter application programming interface. A total of 1408 tweets across three search terms were extracted into Excel; 161 tweets were removed following deduplication and 610 were identified as irrelevant to the research question. The remaining relevant tweets (N=637) were coded into categories using NVivo software, and assigned a positive, neutral, or negative sentiment. To examine views of remote care over time, the coded data were imported back into Excel so that each tweet was associated with both a theme and sentiment. Results The volume of tweets on remote care delivery increased markedly following the COVID-19 outbreak. Five main themes were identified in the tweets: access to remote care (n=267), quality of remote care (n=130), anticipation of remote care (n=39), online booking and asynchronous communication (n=85), and publicizing changes to services or care delivery (n=160). Mixed public attitudes and experiences to the changes in service delivery were found. The proportion of positive tweets regarding access to, and quality of, remote care was higher in the immediate period following the COVID-19 outbreak (March-May 2020) when compared to the time before COVID-19 onset and the time when restrictions from the first lockdown eased (June-October 2020). Conclusions Using Twitter data to address our research questions proved beneficial for providing rapid access to Twitter users’ attitudes to remote care delivery at a time when it would have been difficult to conduct primary research due to COVID-19. This approach allowed us to examine the discourse on remote care over a relatively long period and to explore shifting attitudes of Twitter users at a time of rapid changes in care delivery. The mixed attitudes toward remote care highlight the importance for patients to have a choice over the type of consultation that best suits their needs, and to ensure that the increased use of technology for delivering care does not become a barrier for some. The finding that overall sentiment about remote care was more positive in the early stages of the pandemic but has since declined emphasizes the need for a continued examination of people’s preference, particularly if remote appointments are likely to remain central to health care delivery.
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Affiliation(s)
| | | | - Amy Tallett
- Picker Institute Europe, Oxford, United Kingdom
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Wix SN, Nieva JJ. COVID-19 and the acceleration toward remote cancer care. Proc AMIA Symp 2021; 35:259-260. [PMID: 35261474 PMCID: PMC8865276 DOI: 10.1080/08998280.2021.1984814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The disruption caused by the COVID-19 pandemic has disproportionately affected cancer patients’ access to care. As a result, many specialists in the United States, including oncologists, have adopted telemedicine—a transition largely made possible by reforms to insurer reimbursement schemes. Years after the COVID-19 crisis, there will continue to be a steady demand for remote outpatient visits, particularly in oncology. However, in a health system heavily influenced by reimbursements, strategies to optimize remote oncology care will not be embraced without appropriate incentives. Here we propose that restructuring financial incentives in three areas of cancer care—anticancer drug delivery, wearable health monitoring, and digital data-sharing tools—has the potential to improve patient outcomes, reduce overall costs, and expand clinical trial access for patients in underresourced areas. As with telemedicine, it is time for policymakers to recognize this need and adjust the incentives, both for routine care and for clinical trials, to make it possible.
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Affiliation(s)
- Sophia N. Wix
- Texas Christian University and University of North Texas Health Science Center School of Medicine, Fort Worth, Texas
| | - Jorge J. Nieva
- Department of Medicine, Keck School of Medicine, USC/Norris Cancer Center, Los Angeles, California
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Breen KE, Tuman M, Bertelsen CE, Sheehan M, Wylie D, Fleischut MH, Offit K, Stadler ZK, Salo-Mullen EE, Hamilton JG. Factors Influencing Patient Preferences for Telehealth Cancer Genetic Counseling During the COVID-19 Pandemic. JCO Oncol Pract 2021; 18:e462-e471. [PMID: 34652959 DOI: 10.1200/op.21.00301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PURPOSE With onset of the COVID-19 pandemic, telehealth became the primary modality for health care appointments. This study examined patient experiences with and preferences for telehealth at a cancer genetic counseling clinic throughout the first 6 months of the pandemic (March-August 2020). METHODS An anonymous survey assessed patient demographics; usage and prior experience with technology; emotional responses, technical experiences, and satisfaction with the telehealth appointment (via the Genetic Counseling Satisfaction Scale and Visit-Specific Satisfaction Questionnaire); preference for future telehealth; and recommendation of telehealth to others. RESULTS Among 380 respondents, most were highly satisfied with the telehealth appointment (with 65.6% and 66.4% of participants completing the Genetic Counseling Satisfaction Scale and Visit-Specific Satisfaction Questionnaire, respectively). Multivariable analyses indicated several notable findings. Adjusting for relevant covariates, participants with less education felt significantly more concerned about telehealth than those with highest educational attainment. Participants age 40-69 years were generally more comfortable, relieved, and grateful that their appointment was scheduled as telehealth than were those older than 70 years. Women were marginally more relieved and grateful for telehealth appointments than men. As the pandemic progressed, significantly more participants were highly satisfied with their telehealth appointment and participants trended toward having greater preferences for future telehealth use. Most participants (78.6%) would recommend telehealth to others, although 50.8% preferred future in-person appointments. CONCLUSION As the pandemic progressed, patients expressed increasing preferences for and satisfaction with telehealth. Service delivery models that incorporate individual patient preferences should be developed with special consideration to factors such as age, sex, and education level.
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Affiliation(s)
- Kelsey E Breen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Malwina Tuman
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Corinna E Bertelsen
- Department of Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Margaret Sheehan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - David Wylie
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Kenneth Offit
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Zsofia K Stadler
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Erin E Salo-Mullen
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jada G Hamilton
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.,Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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Nimgaonkar V, Aggarwal C, Berman AT, Gabriel P, Shulman LN, Kucharczuk J, Roy M, Bauml JM, Singh AP, Cohen RB, Langer CJ, Marmarelis ME. Impact of telemedicine adoption on accessibility and time to treatment in patients with thoracic malignancies during the COVID-19 pandemic. BMC Cancer 2021; 21:1094. [PMID: 34635061 PMCID: PMC8503709 DOI: 10.1186/s12885-021-08819-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 09/30/2021] [Indexed: 12/17/2022] Open
Abstract
Background To ensure safe delivery of oncologic care during the COVID-19 pandemic, telemedicine has been rapidly adopted. However, little data exist on the impact of telemedicine on quality and accessibility of oncologic care. This study assessed whether conducting an office visit for thoracic oncology patients via telemedicine affected time to treatment initiation and accessibility. Methods This was a retrospective cohort study of patients with thoracic malignancies seen by a multidisciplinary team during the first surge of COVID-19 cases in Philadelphia (March 1 to June 30, 2020). Patients with an index visit for a new phase of care, defined as a new diagnosis, local recurrence, or newly discovered metastatic disease, were included. Results 240 distinct patients with thoracic malignancies were seen: 132 patients (55.0%) were seen initially in-person vs 108 (45.0%) via telemedicine. The majority of visits were for a diagnosis of a new thoracic cancer (87.5%). Among newly diagnosed patients referred to the thoracic oncology team, the median time from referral to initial visit was significantly shorter amongst the patients seen via telemedicine vs. in-person (median 5.0 vs. 6.5 days, p < 0.001). Patients received surgery (32.5%), radiation (24.2%), or systemic therapy (30.4%). Time from initial visit to treatment initiation by modality did not differ by telemedicine vs in-person: surgery (22 vs 16 days, p = 0.47), radiation (27.5 vs 27.5 days, p = 0.86, systemic therapy (15 vs 13 days, p = 0.45). Conclusions Rapid adoption of telemedicine allowed timely delivery of oncologic care during the initial surge of the COVID19 pandemic by a thoracic oncology multi-disciplinary clinic.
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Affiliation(s)
- Vivek Nimgaonkar
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Charu Aggarwal
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Abigail T Berman
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Peter Gabriel
- Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence N Shulman
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Kucharczuk
- Division of Thoracic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Megan Roy
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Joshua M Bauml
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aditi P Singh
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roger B Cohen
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Corey J Langer
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Melina E Marmarelis
- Division of Hematology and Oncology, Department of Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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