Cancer Patients’ Experiences with Telehealth before and during the COVID-19 Pandemic in British Columbia

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.

Virtual follow‐up care among breast and prostate cancer patients during and beyond the COVID‐19 pandemic: Association with distress

“…Although the majority (86%) of breast and prostate cancer patients were satisfied with VFU, 16% fewer would want VFU in the future. While these findings align with trends in Canada and elsewhere, the proportion of cancer patients who reported that they would be interested in VFU beyond COVID‐19 is higher than that reported in other studies 33,41,42 . For example, of 343 breast cancer survivors receiving telephone‐VFU during the COVID‐19 pandemic in Italy, 80.3% were satisfied, but only 43.8% would want it in the future 24 .…”

“…In their study of cancer patients in British Columbia, Izadi-Najafabadi et al found that lower perceived ease of use of telehealth and less education were associated with cancer patients' satisfaction with virtual care across the continuum of care. 42 Additionally, older age, female sex, non-white race, lower education, and living in an urban environment were associated with a lower likelihood of wanting telehealth after the pandemic. An earlier study by Berlin et al of patients at various phases of the cancer journey recruited from the same institution found that patient satisfaction with virtual care was associated with sex and income, but not with age or equity indexes.…”

“…In a multi‐centre study of virtual care during the COVID‐19 pandemic involving 1299 breast cancer survivors from 18 hospitals in France and Italy, having minimal to severe anxiety (as measured by HADS) was associated with significantly lower levels of virtual care satisfaction 44 . Likewise, in a study of 1382 cancer patients in British Columbia Canada, having low mental health scores (as measured by the VR‐12 MCS sub‐scale) was associated with lower preferences for virtual visits if offered after the COVID‐19 pandemic 42 . The association between increased distress and less satisfaction with VFU may be due to the perception that physicians provide better emotional support during in‐person visits, which is important to those experiencing anxiety or depression.…”

“…In their study of cancer patients in British Columbia, Izadi‐Najafabadi et al. found that lower perceived ease of use of telehealth and less education were associated with cancer patients' satisfaction with virtual care across the continuum of care 42 . Additionally, older age, female sex, non‐white race, lower education, and living in an urban environment were associated with a lower likelihood of wanting telehealth after the pandemic.…”

“You matter”: patients perceptions and disparities about cancer care and telehealth during and after COVID-19 pandemic

“…This is consistent with published literature reporting a general satisfaction with telemedicine [ 38 – 40 ] but a comparatively reduced satisfaction among older patients. Possible reasons may be that telehealth does not simulate the traditional patient experience (e.g., no physical examination) and requires them to be trained on technology, eventually compromising the clinician-patient relationship and the availability of resources and referrals for that population [ 41 – 43 ]. We also observed a racial discrepancy concerning the frequency of contact with health care providers, with black patients indicating lower levels of in-person contact with their physicians compared to non-black patients.…”