Adopting Telemedicine As a Treatment Modality to Offer Remote Support to Older Adult Oncology Patients

Background: Despite significant advances in cancer treatment, cancer rates vary by gender, age, race, and geographic location (e.g., metropolitan/urban or nonmetropolitan/rural). The CDC reported in 2017 that between 1999-2015, the rate of cancer-related deaths decreased in the United States. However, decreases were slower in rural areas. Telemedicine (or telehealth) is the use of technology to overcome the barriers of cost and distance to the provision of optimal care.  The need for telemedicine is great—not just for reliable long-distance interpretations of physiological symptoms and real-time personalized virtual home visits, but also for psychosocial supportive care during and after treatment during cancer survivorship.

Methods: This exploratory study aimed to evaluate the use of telemedicine platforms in providing psychosocial support to older adult oncology patients who may lack access to care due to location. Each support group was facilitated by a social worker and nurse. The telemedicine platform for the support group consisted of online and telephone domains. Participants utilized both online and phone systems during sessions held once a week for a total of 5 weeks. Patients were referred by their treating oncologist and consented by a member of the research team. Participants completed a 0-5 Likert Scale survey after each session to assess their experience, and were provided with session summaries after each online support meeting.

Results: The median age of participants was 52 years (n=15). The majority of patients were diagnosed with lung cancer (n=10) and the remainder had mesothelioma (n=5). Using a 0-5 Likert Scale, consistent attendees (n=5) reported support groups were very helpful. Irregular attendees reported mixed feelings ranging from extremely helpful (n= 6) to neutral (n=4). The majority (80%) of attendees participated in support groups prior to ours. Of the patients surveyed, more than 50% said they would participate in future telehealth (e.g., video chat-formatted) support groups.

Conclusions: Active participation in mixed telephone and online support groups allowed remote cancer patients to share their experiences and concerns about their diagnoses comfortably, supporting transition beyond active treatment. The virtual space gave group participants the opportunity to participate in support groups without having to leave their home, in addition to providing a space for them to reflect on responses outside the main dialogue of support sessions.