Moving Forwards with Telehealth in Cancer Rehabilitation: Patient Perspectives from a Mixed Methods Study (Preprint)

BACKGROUND The COVID-19 pandemic accelerated the use of telehealth in cancer care and highlighted the potential of telehealth as a means of delivery of much needed rehabilitation services for patients living with the side effects of cancer and its’ treatments. OBJECTIVE This mixed methods study aimed to explore patients’ experiences of telehealth and their preferences regarding the use of telehealth for cancer rehabilitation to inform service development. METHODS The study was completed in two phases from October 2020 to November 2021. In phase I, an anonymous scoping survey (online and paper-based) exploring the need, benefits, barriers, facilitators and preferences for telehealth cancer rehabilitation was distributed to cancer survivors in Ireland. In phase II, cancer survivors were invited to take part in semi structured interviews exploring their experiences of telehealth and its role in cancer rehabilitation. Interviews were conducted via telephone/video call following an interview guide informed by the results of the scoping survey, transcribed verbatim, and reflexive thematic analysis was performed using a qualitative descriptive approach. RESULTS Scoping Survey: 48 valid responses were received. Respondents were a median (range) 26 (3-256) months post diagnosis, 23(48%) of whom had completed treatment. Thirty-one (64.5%) reported using telehealth since the start of the pandemic, 15(31.25%) had experience of online cancer rehabilitation, and 43(89.6%) reported a willingness for online cancer rehabilitation. Twenty-six (54.2%) of respondents reported their views on telehealth had changed positively since the start of the pandemic. Semi-Structured Interviews: Interviews were held with 18 cancer survivors (age(mean(SD) 58.9 (8.24) years, male n=8 (44.4%), female n=10 (55.6%),11 (61%) of whom had completed treatment Reflexive thematic analysis identified 5 key themes: i) telehealth improves accessibility to cancer rehabilitation for some but is a barrier for others; ii) lived experiences of the benefits of telehealth in cancer survivorship; iii) the value of in-person healthcare; iv) telehealth in cancer care and COVID-19 – from novelty to normality; and v) the future of telehealth in cancer rehabilitation. CONCLUSIONS Telehealth is broadly welcomed as a mode of cancer rehabilitation for patients living with and beyond cancer in Ireland. However, issues of accessibility and the importance of in-person care must be acknowledged. Factors of convenience, time savings and cost savings mean telehealth interventions are a desirable patient-centred methods of delivering care, when done in suitable clinical contexts and with appropriate populations. CLINICALTRIAL N/A