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|Theme Type=Other
|Has Parent Theme=Theme:02042817-c0de-4a97-a33e-569f41793062
|Title=Telemedicine services for oncology patients
|Is About=Teleoncology involves the remote delivery of cancer care services, a field that has seen rapid expansion following the COVID-19 pandemic. While it offers significant potential to increase healthcare access, its implementation in oncology requires careful consideration of clinical and ethical standards (1).
|Important Because=Telemedicine acceptance among patients with cancer:

Acceptance is a critical precursor to sustained telemedicine adoption. For oncology patients, acceptance is a complex behaviour change that often challenges established healthcare norms (2).<div></div>
|Important For=Policy Maker;Health Care Professional;Regulator;Research Manager / Administrator;Researcher
|Has Best Practice=Remote monitoring and follow-up: Telemedicine is widely utilized for the follow-up of various cancers, including colorectal, endometrial, and prostate cancers. It has proven effective for monitoring patient-reported outcomes and managing chronic haematological malignancies (2).

Psychosocial support: In radiation oncology, tele-consultations (video or telephone) have been used to provide psychological support to patients both during and after radiotherapy. Evidence indicates that tele-visits can effectively reduce distress and improve coping strategies in these patients (3).

Adherence and education: Digital tools, such as mobile applications, are increasingly used to provide information about disease progression and to send reminders that improve treatment adherence for oral anticancer medications (4).

Decentralized research: Telemedicine significantly supports clinical research by facilitating remote consent, qualitative interviews, and the collection of biometric or neurocognitive data (1).

The "human touch" and emotional nuance: Practitioners have noted that while tele-visits are effective for routine support, they may be less precise for psychological evaluations where assessing "expression throughout the body" is difficult (3).

Standard of care vs. accessibility: There is a persistent debate regarding whether tele-consultations can fully replace face-to-face visits. For instance, while tele-psychological support is highly compliant, research suggests that anxiety may be better controlled through on-site visits where direct interaction is possible (3).

Diagnostic limitations: The inability to perform a physical exam remains a leading concern for both patients and physicians, potentially impacting the diagnostic accuracy of remote visits (5).

References:


1. Loh KP, Wang Y, Yilmaz S, Nightingale CL, Parsons SK, Braun-Inglis C, Gada U, Montes A, Magnuson A, Culakova E, Strause S, Kamen C, Dressler E, Mustian K, Morrow G, Mohile S;Landscape Committee. Information Technology and Telemedicine Services in Community Oncology Practices. JCO Clin Cancer Inform. 2023 Aug;7:e2300086. doi: 10.1200/CCI.23.00086. PMID: 37540817;PMCID: PMC10569779.

2. Pang NQ, Lau J, Fong SY, Wong CY, Tan KK. Telemedicine Acceptance Among Older Adult Patients With Cancer: Scoping Review. J Med Internet Res. 2022 Mar 29;24(3):e28724. doi: 10.2196/28724. PMID: 35348462;PMCID: PMC9006130.

3. Caliandro M, Carbonara R, Surgo A, Ciliberti MP, Di Guglielmo FC, Bonaparte I, Paulicelli E, Gregucci F, Turchiano A, Fiorentino A. The Role of Telemedicine for Psychological Support for Oncological Patients Who Have Received Radiotherapy. Curr Oncol. 2023 May 19;30(5):5158-5167. doi: 10.3390/curroncol30050390. PMID: 37232848;PMCID: PMC10217284.

4. Cunha CE, Fernandes R, Santos CX, Boccaletti KW, Pellizzon ACA, Barbosa JHO. Viability of mobile applications for remote support of radiotherapy patients. Rev Assoc Med Bras (1992). 2019 Nov 7;65(10):1321-1326. doi: 10.1590/1806-9282.65.10.1321. PMID: 31721966.

5. West HJ, Barzi A, Wong D. Telemedicine in Cancer Care Beyond the COVID-19 Pandemic: Oncology 2.0? Curr Oncol Rep. 2022 Dec;24(12):1843-1850. doi: 10.1007/s11912-022-01332-x. Epub 2022 Oct 8. PMID: 36208400;PMCID: PMC9547555.<div></div><div></div><div></div>
|Has Detail=Facilitators and barriers to  acceptance:

Convenience and cost reduction: Convenience is the most frequently cited facilitator for oncology patients. Telemedicine reduces the "transportation burden" and associated costs, which is particularly beneficial for patients with physical disabilities (3).

Improved safety and privacy: Especially during the COVID-19 pandemic, patients accepted telemedicine to avoid infection risks in hospital settings. Furthermore, some patients report that telephone follow-ups provide a greater sense of privacy than in-person hospital appointments (2).

Physician recommendation: Trust in the provider plays a crucial role;patients are significantly more likely to download or use a health application if it is recommended by their physician (2).

The digital divide and "telemedicine unreadiness": Older patients (specifically those over 75) are more likely to be "telemedicine unready" due to hearing or vision impairments, lack of internet-enabled hardware, or limited technical skills (5).

Preference for personal connection: A significant barrier is the high value patients place on personal, face-to-face interaction with their physicians. Some studies indicate that even after successful use during the pandemic, the majority of patients were not inclined to continue with telehealth because they felt the distancing was a "bigger toll" than the risk of infection (2).

Security and trust concerns: Concerns regarding data protection, confidentiality, and the potential for technical difficulties often decrease a patient's trust and willingness to use these services (2).<div></div>
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