University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH
Melinda Laine Hsu, Annie Zhang, Carley Mitchell, Changchuan Jiang, Hui Xie, Yaning Zhang, Chi Wen, Yannan Li, Qian Wang
Background: Telehealth use has risen steeply since the COVID-19 pandemic, alongside acceptability among patients and providers. Patients with cancer have reported positive experiences with telemedicine, although concerns of inequity in technology access and digital literacy remain. As cancer survivors (CS) are an older population, it is unknown if CS are less likely to utilize telehealth compared to the general population (GP). Methods: Adult participants were extracted from the nationally representative database Health Information National Trends Survey 6 (3/2022-11/2022). Chi-square tests compared the prevalence of telehealth use in the last 12 months, and logistic regression was used to calculate adjusted odds ratio (aOR) and 95% CI comparing CS vs the GP. We further explored reasons for telehealth visits and perceptions related to telehealth. All calculations were weighted using SAS 9.4. Significance level was set at 2-sided p < 0.05. Results: A total of weighted 239,557,883 individuals were extracted, with 7.7% CS. Adjusting for confounders, the use of telehealth was significantly higher in CS than the GP (Table). Among those who used telehealth, CS were more likely to have telehealth recommended/required by healthcare providers (HCP) and less likely to attribute their use of telehealth to infection concerns or privacy than their non-cancer peers. No difference was observed regarding using telehealth for convenience, including friends/families, technical difficulties, or equivalence with in-person visits between CS vs the GP. Conclusions: CS used telehealth in the last year significantly more than the GP even when controlling for age. Telehealth was more likely to be recommended or required by their HCP, which may be a driver behind increased usage in CS. Digital literacy may not be a barrier to telehealth use in CS, as they did not experience more difficulties in their telehealth visits. Over half of CS did not use telehealth, however, and research is needed to characterize predictors of telehealth use in CS.
General population (%) | Cancer survivors (%) | p-value | aOR 95%CI* | ||
---|---|---|---|---|---|
Overall telehealth usage | 38.4 (36.2-40.5) | 48.2 (41.4-54.9) | 0.01 | 1.48 (1.07-2.04) | |
Reason for telehealth (among telehealth users) | |||||
Recommended by HCP | 72.9 (70.0-75.7) | 79.4 (73.3-85.4) | 0.07 | 1.51 (0.97-2.35) | |
Avoid infection | 51.5 (47.5-55.5) | 36.9 (27.6-46.2) | <0.01 | 0.63 (0.40-1.00) | |
Convenience | 66.6 (63.1-70.0) | 56.6 (47.2-66.1) | 0.05 | 0.80 (0.50-1.30) | |
Including friends/families | 22.6 (19.1-26.2) | 23.5 (15.3-31.8) | 0.84 | 0.99 (0.55-1.76) | |
Difficulty in telehealth visit | 18.2 (1.8-14.7) | 25.7 (3.8-18.2) | 0.08 | 1.36 (0.82-2.25) | |
Telehealth is as good as in-person | 75.8 (1.9-72.0) | 75.3 (3.0-69.3) | 0.89 | 0.90 (0.60-1.33) | |
Privacy concerns with telehealth | 15.9 (2.1-11.7) | 10.4 (2.2-6.1) | 0.07 | 0.43 (0.21-0.89) |
*Model adjusted for age, sex, race, income, education, marital status, BMI, employment, insurance, physical activity, diabetes, hypertension, lung disease, heart disease and smoking status.
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2023 ASCO Annual Meeting
First Author: Min Jee Lee
2023 ASCO Quality Care Symposium
First Author: Youmin Cho
2023 ASCO Annual Meeting
First Author: Cindy Im
2021 ASCO Annual Meeting
First Author: Nausheen Ahmed