Cross-sectoral video consultations in cancer care: perspectives of cancer patients, oncologists and general practitioners

Theis Bitz Trabjerg, Lars Henrik Jensen, Jens Søndergaard, Jeffrey James Sisler, Dorte Gilså Hansen, Theis Bitz Trabjerg, Lars Henrik Jensen, Jens Søndergaard, Jeffrey James Sisler, Dorte Gilså Hansen

Abstract

Purpose: Multidisciplinary video consultations are one method of improving coherence and coordination of care in cancer patients, but knowledge of user perspectives is lacking. Continuity of care is expected to have a significant impact on the quality of cancer care. Enhanced task clarification and shared responsibility between the patient, oncologist and general practitioner through video consultations might provide enhanced continuity in cancer care.

Method: We used descriptive survey data from patients and doctors in the intervention group based on a randomised controlled trial to evaluate the user perspectives and fidelity of the intervention.

Results: Patients expressed that they were able to present their concerns in 95% of the consultations, and believed it was beneficial to have both their doctors present in 84%. The general practitioner and oncologist found that tripartite video consultation would lead to better coordination of care in almost 90% of the consultations. However, the benefits of handling social issues and comorbidity were sparser. Consultations were not accomplished in 11% due to technical problems and sound and video quality were non-satisfactory in 20%.

Conclusion: Overall, multidisciplinary video consultations between cancer patient, general practitioner and oncologist were feasible in daily clinics. Initial barriers to address were technical issues and seamless planning. Patients reported high satisfaction, patient centredness and clarity of roles. General practitioners and oncologists were overall positive regarding role clarification and continuity, although less pronounced than patients.

Trial registration: www.clincialtrials.gov , NCT02716168.

Keywords: Cancer; General practice; Technical fidelity; User perspectives; Video consultation.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
The consultation guide to GPs and oncologists, including themes potentially relevant for the consultation
Fig. 2
Fig. 2
Flowchart of participants enrolled in the randomised controlled trial “The Partnership Project”. From randomisation to survey participation

References

    1. Plate S, Emilsson L, Soderberg M, Brandberg Y, Warnberg F. High experienced continuity in breast cancer care is associated with high health related quality of life. BMC Health Serv Res. 2018;18:127.
    1. Haggerty JL, Reid RJ, Freeman GK, Starfield BH, Adair CE, Mc Kendry R. Continuity of care: a multidisciplinary review. BMJ. 2003;327:1219–1221.
    1. King M, Jones L, Richardson A, Murad S, Irving A, Aslett H, Ramsay A, Coelho H, Andreou P, Tookman A, Mason C, Nazareth I. The relationship between patients’ experiences of continuity of cancer care and health outcomes: a mixed methods study. Br J Cancer. 2008;98:529–536.
    1. Smith SM, Allwright S, O’Dowd T. Does sharing care across the primary-specialty interface improve outcomes in chronic disease?. A systematic review. Am J Manag Care. 2008;14:213–224.
    1. Taplin SH, Rodgers AB. Toward improving the quality of cancer care: addressing the interfaces of primary and oncology-related subspecialty care. J Natl Cancer Inst Monogr. 2010;2010:3–10.
    1. Sussman J, Baldwin LM. The interface of primary and oncology specialty care: from diagnosis through primary treatment. J Natl Cancer Inst Monogr. 2010;2010:18–24.
    1. Guassora AD, Jarlbaek L, Thorsen T. Preparing general practitioners to receive cancer patients following treatment in secondary care: a qualitative study. BMC Health Serv Res. 2015;15:202.
    1. Potosky AL, Han PK, Rowland J, Klabunde CN, Smith T, Aziz N, Earle C, Ayanian JZ, Ganz PA, Stefanek M. Differences between primary care physicians’ and oncologists’ knowledge, attitudes and practices regarding the care of cancer survivors. J Gen Intern Med. 2011;26:1403–1410.
    1. Barry MJ, Edgman-Levitan S. Shared decision making-pinnacle of patient-centered care. N Engl J Med. 2012;366:780–781.
    1. Duggal R, Brindle I, Bagenal J. Digital healthcare: regulating the revolution. BMJ. 2018;360:k6.
    1. Marshall M, Shah R, Stokes-Lampard H. Online consulting in general practice: making the move from disruptive innovation to mainstream service. BMJ. 2018;360:k1195.
    1. Sabesan S, Allen DT, Caldwell P, Loh PK, Mozer R, Komesaroff PA, Talman P, Williams M, Shaheen N, Grabinski O, Royal Australasian College of Physicians Telehealth Working G Practical aspects of telehealth: establishing telehealth in an institution. Intern Med J. 2014;44:202–205.
    1. Kitamura C, Zurawel-Balaura L, Wong RK. How effective is video consultation in clinical oncology? A systematic review. Curr Oncol. 2010;17:17–27.
    1. Allen DT, Caldwell P, Komesaroff PA, Loh PK, Mozer R, Sabesan S, Shaheen N, Talman P, Williams M, Grabinski O, Royal Australasian College of Physicians Telehealth Working G Practical aspects of telehealth: set-up and preparation for video consultations. Intern Med J. 2013;43:1133–1136.
    1. Sabesan S, Allen D, Caldwell P, Loh PK, Mozer R, Komesaroff PA, Talman P, Williams M, Shaheen N, Grabinski O, Royal Australasian College of Physicians Telehealth Working G Practical aspects of telehealth: doctor-patient relationship and communication. Intern Med J. 2014;44:101–103.
    1. Fleissig A, Jenkins V, Catt S, Fallowfield L. Multidisciplinary teams in cancer care: are they effective in the UK? Lancet Oncol. 2006;7:935–943.
    1. Pype P, Mertens F, Belche J, Duchesnes C, Kohn L, Sercu M, Deveugele M. Experiences of hospital-based multidisciplinary team meetings in oncology: an interview study among participating general practitioners. Eur J Gen Pract. 2017;23:155–163.
    1. Chaillou D, Mortuaire G, Deken-Delannoy V, Rysman B, Chevalier D, Mouawad F. Presence in head and neck cancer multidisciplinary team meeting: the patient’s experience and satisfaction. Eur Ann Otorhinolaryngol Head Neck Dis. 2019;136:75–82.
    1. Myhre A, Agai M, Dundas I, Feragen KB. “All eyes on me”: a qualitative study of parent and patient experiences of multidisciplinary care in craniofacial conditions. Cleft Palate-Craniofacial J : official publication of the American Cleft Palate-Craniofacial Association. 2019;56(9):1187–1194.
    1. Funderskov KF, Raunkiaer M, Danbjorg DB, Zwisler AD, Munk L, Jess M, Dieperink KB. Experiences with video consultations in specialized palliative home-care: qualitative study of patient and relative perspectives. J Med Internet Res. 2019;21:e10208.
    1. Jess M, Timm H, Dieperink KB. Video consultations in palliative care: a systematic integrative review. Palliat Med. 2019;33:942–958.
    1. Trabjerg TB, Jensen LH, Sondergaard J, Sisler JJ, Hansen DG. Improving continuity by bringing the cancer patient, general practitioner and oncologist together in a shared video-based consultation-protocol for a randomised controlled trial. BMC Fam Pract. 2019;20:86.
    1. Silverman J, Kurtz, S., Draper, J. (2013) Skills for communicating with patients Radcliffe Publishing Ltd, UK
    1. Holm LV, Hansen DG, Johansen C, Vedsted P, Larsen PV, Kragstrup J, Sondergaard J. Participation in cancer rehabilitation and unmet needs: a population-based cohort study. Support Care Cancer. 2012;20:2913–2924.
    1. (2013) Australian College of Rural and Remote Medicine. Handbook for the Telehealth Online Education Module. In: Editor (ed)^(eds) Book Australian College of Rural and Remote Medicine. Handbook for the Telehealth Online Education Module, City
    1. Sabesan S, Allen D, Loh PK, Caldwell P, Mozer R, Komesaroff PA, Talman P, Williams M, Shaheen N, Royal Australasian College of Physicians Telehealth Working G Practical aspects of telehealth: are my patients suited to telehealth? Intern Med J. 2013;43:581–584.
    1. Pedersen KM, Andersen JS, Sondergaard J. General practice and primary health care in Denmark. J Am Board Fam Med. 2012;25(Suppl 1):S34–S38.
    1. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381.
    1. Bergholdt SH, Hansen DG, Larsen PV, Kragstrup J, Sondergaard J. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners. BMJ Open. 2013;3:e002726.
    1. Bergholdt SH, Larsen PV, Kragstrup J, Sondergaard J, Hansen DG. Enhanced involvement of general practitioners in cancer rehabilitation: a randomised controlled trial. BMJ Open. 2012;2:e000764.
    1. Wulff CN, Vedsted P, Sondergaard J. A randomised controlled trial of hospital-based case management to improve colorectal cancer patients’ health-related quality of life and evaluations of care. BMJ Open. 2012;2:e001481.
    1. Pereira Gray DJ, Sidaway-Lee K, White E, Thorne A, Evans PH. Continuity of care with doctors-a matter of life and death? A systematic review of continuity of care and mortality. BMJ Open. 2018;8:e021161.
    1. Haggerty JL, Roberge D, Freeman GK, Beaulieu C. Experienced continuity of care when patients see multiple clinicians: a qualitative metasummary. Ann Fam Med. 2013;11:262–271.
    1. Clauser SB, Wagner EH, Aiello Bowles EJ, Tuzzio L, Greene SM. Improving modern cancer care through information technology. Am J Prev Med. 2011;40:S198–S207.
    1. Lawrence RA, McLoone JK, Wakefield CE, Cohn RJ. Primary care physicians’ perspectives of their role in cancer care: a systematic review. J Gen Intern Med. 2016;31:1222–1236.
    1. Walsh J, Harrison JD, Young JM, Butow PN, Solomon MJ, Masya L. What are the current barriers to effective cancer care coordination? A qualitative study. BMC Health Serv Res. 2010;10:132.
    1. Sogaard M, Thomsen RW, Bossen KS, Sorensen HT, Norgaard M. The impact of comorbidity on cancer survival: a review. Clin Epidemiol. 2013;5:3–29.
    1. (2013) The needs and experiences of cancer patients through the trajectory. The Danish Cancer Society’s Barometer Survey. In: Editor (ed)^(eds) Book The needs and experiences of cancer patients through the trajectory. The Danish Cancer Society’s Barometer Survey. Danish Cancer society, City, pp. 123
    1. Flodgren G, Rachas A, Farmer AJ, Inzitari M, Shepperd S. Interactive telemedicine: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2015;2015:CD002098.
    1. Draugalis JR, Coons SJ, Plaza CM. Best practices for survey research reports: a synopsis for authors and reviewers. Am J Pharm Educ. 2008;72:11.
    1. Boynton PM, Greenhalgh T. Selecting, designing, and developing your questionnaire. BMJ. 2004;328:1312–1315.
    1. Dahler-Eriksen K, Nielsen JD, Lassen JF, Olesen F. Cross-sectional therapeutic programs-an example of a cooperative health care system. A review with comments. Ugeskr Laeger. 1998;160:5021–5024.
    1. Steffensen KD, Vinter M, Cruger D, Dankl K, Coulter A, Stuart B, Berry LL. Lessons in integrating shared decision-making into cancer care. J Oncol Pract. 2018;14:229–235.
    1. Ammentorp J, Graugaard LT, Lau ME, Andersen TP, Waidtlow K, Kofoed PE. Mandatory communication training of all employees with patient contact. Patient Educ Couns. 2014;95:429–432.
    1. Greenhalgh T, Shaw S, Wherton J, Vijayaraghavan S, Morris J, Bhattacharya S, Hanson P, Campbell-Richards D, Ramoutar S, Collard A, Hodkinson I. Real-world implementation of video outpatient consultations at macro, meso, and micro levels: mixed-method study. J Med Internet Res. 2018;20:e150.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다