Shadow study: randomized comparison of clinic with video follow-up in glioma undergoing adjuvant temozolomide therapy

Abstract

Aim:This study was designed with a primary objective to study the rate of agreement in treatment plan and decisions between video follow-up (VF) and conventional clinic follow-up (CF).Patients & methods:Adult patients with intermediate- to high-grade glioma on adjuvant temozolomide (TMZ) with facilities for live video call were invited to participate in the study.Results:The concurrence in decision of administering TMZ between VF and CF was 100% (p < 0.00). The median cost incurred in VF was US$58.15 while that incurred in CF was US$131.23 (p < 0.00).Conclusion:VF can substitute CF during adjuvant TMZ administration (CTRI/2017/01/007626).

Use of telehealth platforms for delivering supportive care to adults with primary brain tumors and their family caregivers: A systematic review

“…Patil et al 44 evaluated feasibility and safety of video clinic reviews for 65 adults with glioma (II‐IV) who had completed ≥2 cycles of adjuvant temozolomide. All received conventional (in‐person) follow‐up initially and then video follow‐up.…”

“…Importantly, participants with high levels of adherence, or those completing the intervention typically reported high levels of acceptability or satisfaction ( M = 81%) irrespective of the mode of communication 40,43,44,48–52 . In the only study to compare mode of delivery, Patil et al 44 found that the level of satisfaction with video clinic follow‐up (extremely satisfied = 80%) was comparable to conventional face‐to‐face follow‐up (extremely satisfied = 86%). Furthermore, video follow‐up was associated with less than half the costs of conventional follow‐up, which is likely to be a key consideration for implementation in practice 57 …”

“…The studies evaluated telehealth interventions addressing five aspects of supportive care, including symptom review and post-treatment follow-up, 43,44 information and educational support, 40,[45][46][47][48] physical exercise, 49 cognitive rehabilitation 50,51 and psychological support. 38,41,42,[52][53][54] Telehealth platforms included telephone-based support, 40,42,43,48,53 videoconferencing, 41,44,54 web-based programs and resources [45][46][47][49][50][51][52] or combined use of videoconferencing and self-guided web-based modules. 38 Caregivers were involved in 31% of interventions, including three supporting both patients and caregivers 41,42,45,48 and a carer-specific information and support program.…”

“…38 Caregivers were involved in 31% of interventions, including three supporting both patients and caregivers 41,42,45,48 and a carer-specific information and support program. 40 In terms of the nature of communication, eight interventions (50%) involved synchronous communication, or interaction in real-time with professionals, [40][41][42][43][44]48,53,54 whereas four (25%) involved a combination of interaction in real-time and self-guided online programs and resources 38,47,49,50 and four (25%) were mainly self-guided with asynchronous communication, 45,46,51,52 such as delayed email feedback. The following sections summarise the key findings according to the focus of supportive care.…”

Proposed Additions to the NCCN Guidelines for Adult Medulloblastoma

“…An important consideration is that patients with limited resources or living in remote areas might not have access to such centers of excellence. Potential solutions include referrals for expert consultation with care provided in collaboration with local providers, in person, or via telehealth medicine, 18,19 and the implementation of web-based tumor boards 20,21 to review such cases and provide multidisciplinary expert advice. One important component of achieving the goal of referring adults with medulloblastoma to centers of excellence is to educate patients, caregivers, healthcare providers, and thirdparty payers about the benefits of being seen at centers with expertise.…”