Patients'/Caregivers' Perspectives on Telemedicine Service for Advanced Cancer Patients during the COVID-19 Pandemic: An Exploratory Survey

Abstract

Introduction: Novel coronavirus disease 2019 (COVID 19) has usurped human peace and mobility. The confinement of the population and the rising epidemic has disrupted the routine care for non-COVID-19 patients. Telehealth is a growing field, and its application in palliative care is seen as a solution to serve the population in this difficult crisis.

Methodology: A exploratory survey was designed to assess the changes in the hospital-based practice of palliative care in the COVID-19 pandemic and patient/caregiver's perception about the provision of telehealth services to palliative care patients of a tertiary care cancer hospital of eastern India.

Results: There was a dramatic reduction in the outpatient clinic footfalls by 51% with teleconsultation. Although there was no change in the number of emergency visits, the inpatient admissions reduced by 44%. Nearly 82% of patient/caregivers gave a positive feedback about telemedicine care provided by the department and mentioned that the service provided them with support and connectedness. Almost 64% of the patients and caregivers reported that the service helped allay the fear and reassured them that there was a someone to support them. As high as 76% of the participants felt that they would prefer teleconsultation in future and were ready to pay for teleconsultations if charges were to be applied in the future.

Conclusion: Telemedicine is an important tool and an essential service to care for palliative care patients in the community especially when the patient and health-care professionals are separated by a pandemic or natural disaster.

Keywords: Coronavirus disease 2019; palliative care; patient/caregiver's perspective; telemedicine.

Figure 1

Triaging patients using teleconsultation. *Intractable pain or other symptoms such as breathlessness, bleeding etc., that endangers quality of life or increases the risk of death/status epilepticus, agitated delirium/risk of suicide. ^#Moderate symptoms/developed new symptoms warranting physical examination by physician/need a change of prescription such as benzodiazepines, antipsychotics or narcotics. ^!Mild symptoms/need dose titration of the existing prescription/on a scheduled follow-up