Pilot study of an enhanced telehealth program for patients with prostate cancer.

Abstract

1647 Background: The time required for cancer treatment is considerable. Telehealth (TH) with home monitoring can minimize travel burden but patients’ perceptions regarding tradeoffs of clinic visits versus enhanced telehealth (ET) are uncertain. We piloted an ET intervention offering patients on androgen deprivation therapy (ADT) for prostate cancer up to four components of care at home. Methods: Prostate cancer patients on ADT were offered participation in 4 at home services: 1) TH oncologist visits; 2) remote BP monitoring (BP); 3) home phlebotomy (HP); and 4) self-injection of ADT or denosumab at home with RN support via TH as needed. Clinicians referred eligible patients and specified frequency of each service. Completion rates were evaluated for each component. Patient perspectives, preferences for subsequent care, and assessments of the feasibility, acceptability, and appropriateness of each component were collected after participation in eligible services at least once over the course of the pilot. Feasibility, acceptability, and appropriateness were measured by validated measures (scores from 1-5). Patient satisfaction with ET was measured using a net promoter score. All results are based on the last completed patient survey. Results: Between 6/2023 and 6/2024, 39 patients enrolled in the pilot, the median age was 70 (IQR: 61.5-76.7), 62% were white, and 69% (N = 27) lived with family or a partner. Table 1 shows the %/(N) of patients who chose to participate in each at home component with completion rates at the patient and visit level. 73% (145/198) of remote monitoring failures were due to patient inability to execute the at home task. > 75% of patients reported that each service was convenient and saved time. Most patients reported no problems with completing the visit (TH 89%, BP 89%, HP 91%, injections 67%). Patients were either very likely or somewhat likely to participate again (TH 97%, BP 100%, HP 96%, injections 100%) and the majority preferred ET for future care (TH 79%, BP 79%, HP 87%, injections 100%). 62% (24/39) of patients found at-home visits to be equally or less stressful than in-person care. Patients found each service to be feasible, acceptable, and appropriate (mean score > 4.7 for all services) and gave ET a net promotor score of 79. Conclusions: Patients found ET for the management of prostate cancer on ADT to be feasible, acceptable, and appropriate, providing a more patient-centered and convenient alternative to traditional clinic-based care. Future studies will explore scalability and applicability across diverse patient populations and treatment regimens. % (N) Patients opting in for each component % (N) Patients completing each component (at least once) % (N) Total episodes completed TH visits 100% (39) 59% (23) 90% (53/59) Remote BP monitoring 92% (36) 94% (34) 60% (296/494) Home phlebotomy 69% (27) 100% (27) 97% (143/148) Home injections 28% (11) 73% (8) 90% (9/10) All 4 components 18% (7) 29% (2) 70% (501/771)