Telehealth use among cancer survivors.

Authors

null

Melinda Laine Hsu

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

Organizations

University Hospitals Seidman Cancer Center and Case Western Reserve University, Cleveland, OH, University of Texas Southwestern Medical Center, Dallas, TX, Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, Ascension Providence Hospital, Southfield, MI, Mount Sinai Health System, New York, NY, University of British Columbia, Vancouver, BC, Canada, Case Comprehensive Cancer Center, University Hospitals/Seidman Cancer Center, Cleveland, OH

Research Funding

No funding received
None.

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-valueaOR 95%CI*
Overall telehealth usage38.4 (36.2-40.5)48.2 (41.4-54.9)0.011.48 (1.07-2.04)
Reason for telehealth (among telehealth users)
 Recommended by HCP72.9 (70.0-75.7)79.4 (73.3-85.4)0.071.51 (0.97-2.35)
 Avoid infection51.5 (47.5-55.5)36.9 (27.6-46.2)<0.010.63 (0.40-1.00)
 Convenience66.6 (63.1-70.0)56.6 (47.2-66.1)0.050.80 (0.50-1.30)
 Including friends/families22.6 (19.1-26.2)23.5 (15.3-31.8)0.840.99 (0.55-1.76)
Difficulty in telehealth visit18.2 (1.8-14.7)25.7 (3.8-18.2)0.081.36 (0.82-2.25)
Telehealth is as good as in-person75.8 (1.9-72.0)75.3 (3.0-69.3)0.890.90 (0.60-1.33)
Privacy concerns with telehealth15.9 (2.1-11.7)10.4 (2.2-6.1)0.070.43 (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.

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Quality, Safety, and Implementation Science,Cost, Value, and Policy,Patient Experience,Survivorship

Sub Track

Communication and Transitions

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 493)

DOI

10.1200/OP.2023.19.11_suppl.493

Abstract #

493

Poster Bd #

L19

Abstract Disclosures