Background:

The COVID-19 pandemic has catalyzed the use of mobile technologies to deliver health care. This new medical model has benefited integrative oncology (IO) consultations, where cancer patients are counseled about healthy lifestyle, non-pharmacological approaches for symptom management, and addressing questions around natural products and other integrative modalities. Here we report the feasibility of conducting IO physician consultations via telehealth in 2020 and compare patient characteristics to prior in-person consultations conducted in 2019.

Methods:

An integrated EHR-telemedicine platform was used for IO physician consultations. As in the prior in-person visits, patients completed pre-visit patient-reported outcome (PRO) assessments about common cancer symptoms [modified Edmonton Symptom Assessment Scale, (ESAS)], Measure Yourself Concerns and Wellbeing (MYCaW), and the PROMIS-10 to assess quality of life (QOL). Patient demographics, clinical characteristics, and PROs for new telehealth consultation in 2020 were compared to new in-person consultations in 2019 using t-tests, chi-squared tests, and -Wilcoxon rank-sum test.

Results:

We provided telehealth IO consultations to 509 new patients from April 21, 2020, to October 21, 2020, versus 842 new patients in-person during the same period in 2019. Most were female (77 % vs 73%); median age (56 vs 58), and the most frequent cancer type was breast (48% vs 39%). More patients were seeking counseling on herbs and supplements (12.9 vs 6.8%) and lifestyle (diet 22.7 vs 16.9% and exercise 5.2 vs 1.8%) in the 2020 cohort than 2019, respectively. The 2020 telehealth cohort had lower symptom management concerns compared to the 2019 in-person cohort (19.5 vs 33.1%).

Conclusions:

Delivering IO consultations using telehealth is feasible and meets patients’ needs. Compared to patients seen in-person during 2019, patients having telehealth IO consultations in 2020 reported lower symptom burden and more concerns about lifestyle and herbs and supplements. Additional research is warranted to explore the satisfaction and challenges among patients receiving telehealth IO care.

中文翻译：

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2020年通过远程医疗和2019年通过个人进行的肿瘤综合咨询：COVID-19世界大流行期间的范例转变

背景：

COVID-19大流行催化了移动技术的使用，以提供医疗保健。这种新的医学模型有益于综合肿瘤学（IO）咨询，在该咨询中，会为癌症患者提供有关健康生活方式，症状管理的非药物方法以及有关天然产物和其他综合方式的问题的咨询服务。在这里，我们报告了在2020年通过远程医疗进行IO医生咨询的可行性，并将患者特征与2019年进行的亲自咨询相比较。

方法：

集成的EHR远程医疗平台用于IO医师咨询。与以前的亲自拜访一样，患者完成了关于常见癌症症状的预诊患者报告结局（PRO）评估[改良的埃德蒙顿症状评估量表（ESAS）]，衡量自己的关注和健康（MYCaW）以及PROMIS -10评估生活质量（QOL）。使用t检验，卡方检验和-Wilcoxon秩和检验，将2020年新的远程医疗咨询的患者人口统计学特征，临床特征和PRO与2019年新的面对面咨询进行了比较。

结果：

从2020年4月21日到2020年10月21日，我们为509名新患者提供了远程医疗IO咨询，而在2019年同期，则有842名新患者当面就诊。大多数是女性（77％比73％）；中位年龄（56岁对58岁），最常见的癌症类型是乳腺癌（48％对39％）。与2020年相比，分别有更多的患者寻求关于草药和补品（12.9 vs 6.8％）和生活方式（饮食22.7 vs 16.9％和运动5.2 vs 1.8％）的咨询（2019年）。与2019年的面对面队列相比，2020年的远程医疗队列对症状管理的担忧较低（19.5％对33.1％）。

结论：

使用远程医疗进行IO咨询是可行的，并且可以满足患者的需求。与2019年亲自就诊的患者相比，2020年进行远程医疗IO咨询的患者报告的症状负担更低，对生活方式，草药和补品的关注更多。有必要进行更多的研究来探讨接受远程医疗IO护理的患者的满意度和挑战。