Currently submitted to: JMIR Research Protocols
Date Submitted: Jul 23, 2026
Open Peer Review Period: Jul 30, 2026 - Sep 24, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
MATCH-UP: MAking Telehealth-Delivery of Cancer Care at Home Effective and Safe Upscaled: Protocol of a Pragmatic Cluster Randomized Trial of Enhanced Telehealth for Patients with Breast and Prostate Cancer
ABSTRACT
Background:
Telehealth use expanded rapidly during the COVID-19 pandemic, but evidence regarding the safety, effectiveness, and implementation of telehealth-enabled oncology care remains limited. MATCH-UP, is a pragmatic trial designed to evaluate a scalable, enhanced telehealth (ET) care model embedded within routine medical oncology workflows.
Methods:
MATCH-UP is a pragmatic, cluster randomized trial enrolling patients with breast or prostate cancer. Sixty-two physician practice clusters in medical oncology are randomized 1:1 to ET or to usual care (UC), stratified by disease type and clinic volume. Eligible participants have breast or prostate cancer, at least three prior medical oncology visits and are not enrolled on a therapeutic clinical trial. Enrollment through the electronic health record (EHR) is triggered by a medical oncology follow-up visit, with waiver of informed consent. The ET intervention includes several components: 1) default scheduling of telehealth for routine medical oncology follow-up; 2) the option to undergo home phlebotomy; 3) the option to receive select subcutaneous (SC) or intramuscular (IM) medications at home with telehealth assisted nursing supervision; and 4) access to digital support for barriers to telehealth utilization. ET physicians and patients have the option to utilize any or all intervention components based on clinical judgement and preferences. In the UC arm, home phlebotomy and home administration of SC/IM therapy are not available, and telehealth is not the scheduling default.
Results:
The primary endpoint is the proportion of face-to-face visits among all medical oncology related visits over the 12-month follow-up. Secondary outcomes include: 1) healthcare utilization including both ambulatory and acute care; 2) visit cancellation rates; 3) overall survival; 4) patient-reported quality of life (PROMIS Global-10); 5) patient time and indirect costs; 6) patient and physician experience and visit-type preferences. Implementation outcomes include intervention adoption and patient and physicians’ perspectives on its acceptability, appropriateness, and feasibility. The primary endpoint will be evaluated using generalized linear mixed models with a logit link, accounting for clustering of patients within practice units and repeated visits within patients. Implementation outcomes will be summarized descriptively including estimated proportions and 95% confidence intervals for adoption and composite scores derived from stakeholder perspectives on intervention acceptability, appropriateness, and feasibility. Conclusion: MATCH-UP is a cluster randomized pragmatic trial evaluating ET model for delivery of patient-centered longitudinal breast and prostate oncology care.
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