Telehealth in Improving Quality of Life in Patients During Post Radiation Therapy Visits

Not Applicable

Completed

Conditions: Malignant Neoplasm

Interventions: Other: Telemedicine
Other: Questionnaire Administration

Registration Number: NCT02751580

Lead Sponsor: Sidney Kimmel Cancer Center at Thomas Jefferson University

Brief Summary: This pilot clinical trial studies how well telehealth works in patients during post radiation therapy visits. A telehealth virtual office visit can be performed from the patient's home or workplace, decreasing time spent traveling to visit site, time spent in waiting room, and cost to patient. Studying telehealth may improve quality of life in patients during post radiation therapy visit.

Detailed Description: PRIMARY OBJECTIVES:

I. To examine feasibility of conducting a trial comparing a telehealth visit and an in person office visit.

SECONDARY OBJECTIVES:

I. To examine patient satisfaction, patient assessment of physician communication during a telehealth visit.

II. To examine patient distrust in the healthcare system following a telehealth visit.

III. To examine physician ability to perform a patient assessment during a telehealth visit.

IV. To examine physician perceptions of telehealth visits. V. To examine monetary and time cost to patients for telehealth visit. VI. To calculate clinic savings derived from telehealth visits.

OUTLINE:

Patients undergo their first post-treatment visit as a virtual telehealth visit using the JeffConnect application.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 37

Inclusion Criteria

Patients currently undergoing or planned to start radiation treatment with curative, adjuvant or palliative intent
Karnofsky performance status (KPS) score >= 60
Patients must be capable to read and speak English and provide study specific informed consent prior to study entry
Patients must have access to a computer or smartphone and internet connection at home on which they would be willing to do a telehealth study
Pennsylvania or New Jersey residents *Telehealth visits for New Jersey residents will only be performed by physicians with a current medical license issued by the state of New Jersey.

Exclusion Criteria

KPS < 60%
No access to a computer, smartphone or internet
Unable to read and/or speak English
Decisionally impaired patients
Patients not residing in Pennsylvania or New Jersey

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Health services research (telehealth)	Questionnaire Administration	Patients undergo their first post-treatment visit as a virtual telehealth visit using the JeffConnect application downloaded onto their electronic device.
Health services research (telehealth)	Telemedicine	Patients undergo their first post-treatment visit as a virtual telehealth visit using the JeffConnect application downloaded onto their electronic device.

Primary Outcome Measures

Name	Time	Method
Feasibility of Conducting a Future Randomized Clinical Trial Comparing Telehealth and in Person Visits (i.e., Rate of Accrual)	24 months from first patient enrolled	The number of patients accrued each month will be analyzed via Poisson regression. The mean (monthly rate) will be estimated and tested against the null value of 4 patients per month using a 1-sided test with alpha 0.05. The proportion of enrolled subjects who are lost to follow-up will also be summarized.

Secondary Outcome Measures

Name	Time	Method
Clinic Savings Derived From Telehealth Visits	Through study completion	Clinic savings derived from telehealth visits v in-person visits
Patient Costs for Telehealth Visit	Through study completion	Patient costs for telehealth visit based on questionnaire response
Patient Satisfaction With Telehealth Visits as Measured by the Patients Satisfaction With Cancer Care Score	4 months from enrollment	Patients Satisfaction with Cancer Care score is an 18-item questionnaire with answers on a 5-point Likert scale. Lower scores are associated with higher satisfaction with caner care. The average will be computed and tested against the null value of 75 using a one-sample t-test with alpha 0.05.
Number of Patients Satisfied With Physician Communication During Telehealth Visit	4 months from enrollment	14 item communication assessment tool (CAT). The CAT addresses specifically patient satisfaction with key aspects of communication and interpersonal skills and items are scored on a 1-5 scale where 1 = poor and 5 = excellent and a higher score would indicate better communication skills
Physician Satisfaction With Post-treatment Telehealth Visit as Measured by the Modified Physician Satisfaction Scale	4 months from enrollment	9-question survey regarding the ease of use and efficacy of the telehealth platform. The items were yes or no questions (scored on 1=yes and 0=no) scale. Higher scores represented greater satisfaction with the platform. Specifically looked at responses to the items regarding: accurate assessment of symptoms via telehealth, accurately assess treatment-related toxicity via telehealth, feeling sure they obtained all information needed to care for the patient, and if providers would use the telehealth system in the future.
Patient Distrust in the Healthcare System as Measured by the Health Care System Distrust Scale in Relation to Privacy of Medical Record (MR)	4 months from enrollment	healthcare system distrust scale, designed to assess the belief that physicians would act in a patient's best interest to prevent a potentially negative important outcome (ref). This is a 10 item survey scored 1-5 where 1 = "strongly disagree" and 5 = "strongly agree" and higher scores generally indicate more distrust. Patient distrust was measured by asking if patients felt their Medical Record (MR) would be kept private or would be accessed without their permission.
Physicians Ability to Evaluate a Patient During a Telehealth Visit as Measured by the Physician Questionnaire	4 months from enrollment	9 question survey regarding the ease of use and efficacy of the telehealth platform. The items were yes or no questions (scored on 1 = yes and 0 = no) scale. Higher scores represent greater satisfaction with the platform.