Using information and communication technologies to improve the management of pain from advanced cancer in the community: Qualitative study of the experience of implementation for patients and health professionals in a trial

Abstract

In cancer care, there are emerging information and communication technology systems being developed, enabling real-time information sharing between patients and health professionals. This study explored health professionals’ and patients’ perceptions of their engagement with an information and communication technology system for pain management to understand the mechanisms that could support implementation into routine palliative care practice. This was a qualitative study, embedded within a randomised control trial, using semi-structured face-to-face interviews. Data were analysed using thematic analysis. The role of health professionals was a key component to patient engagement with the information and communication technology system. Where patients engaged with the information and communication technology system, both patients and health professionals reported benefits to system use in addition to usual care. Implementation issues were identified that can be used to guide future system development to support pain management in the context of routine clinical care in palliative care services. Where interventions are dependent on multiple providers, collaborative working and consideration of the context within which they are set are needed.

Health Care Professionals’ Experiences and Perspectives on Using Telehealth for Home-based Palliative Care: Scoping Review

“…A frequency table illustrating which papers were included in which descriptive themes was made (Table 1). [66], Scofano et al [67], and Weck et al [68] Easy to use but technological issues undermine confidence 18 Bonsignore et al [69], Collier et al [60], Funderskov et al [49] Hackett et al [70], Helleman et al [71], Oelschlägel et al [62], Read Paul et al [59], Shulver et al [57], Harding et al [52], Whitten et al [56], Hochstenbach et al [50], Lind et al [51], Nguyen et al [48], van Gurp et al [72], Stern et al [55], Haydon et al [66], Scofano et al [67], and Weck et al [68] Adds value but personal and organizational barriers challenge adoption 23 Collier et al [60], Hackett et al [70], Harding et al [52], Hochstenbach et al [50], Lind et al [51], McCall et al [61], Adam et al [54], Funderskov et al [49], Read Paul et al [59], Whitten et al [53], Miyazaki et al [58], Tieman et al [73], van Gurp et al [74], Nguyen et al [48], Whitten et al [56], Oelschlägel et al [62], Shulver et al [57], Alodhayani et al [75], Bhargava et al...…”

“…The sample size of the studies included ranged from 4 to 111 participants, and in 12 papers, the samples consisted of fewer than 10 participants. In all but 1 [68] study, the samples consisted of nurses with various specialties [69][70][71][72][73][74][75]; in 13 studies, physicians were included [47,49,51,52,54,63,64,66,68,70,72,74,75]; and in 3 studies, hospice workers (ie, nurses, physicians, social workers, and spiritual care providers) were included [53,56,64]. Eleven studies had multiprofessional perspectives, including HCPs within rehabilitation, allied health, residential care, and palliative care [57,66]; case managers, coordinators, and respiratory therapists [58]; physician consultants [59]; telehealth providers or technologists [69,75]; and rehabilitation physicians, occupational therapists, physical therapists, speech therapists, dieticians, and social workers [49,62,71].…”

“…In the majority of the studies (n=13), patients with cancer receiving palliative care were the recipients of the telehealth intervention [49][50][51]54,55,59,[61][62][63]70,[72][73][74]. Eleven studies did not report specific diagnoses other than serious illnesses [47,48,57,58] or patients receiving palliative care [60,65,66,69] or end-of-life care [53,56,64].…”

“…Thirteen papers used a qualitative design [49][50][51]53,54,57,60,62,66,70,72,74,75], 12 papers used a mixed or multimethods design [47,52,55,56,58,59,61,64,[67][68][69]71], and 4 papers used a quantitative design [48,63,65,73]. The characteristics of the studies included are shown in Multimedia Appendix 4.…”

“…HCPs reported that telehealth added value to HBPC, as it improved their access to patients, facilitated quick and timely responses, and improved time efficiency, quality, coordination, and continuity of care without increasing their overall workload compared with in-person visits [49,59,60,62,66,[68][69][70][71]76]. For rural HCPs, an added benefit was that video visits increased the capacity and extension of palliative care services while minimizing the need for traveling [57,60,66,69].…”