Challenges of cross-sectoral video consultation in cancer care on patients’ perceived coordination: A randomized controlled trial
ABSTRACT
Background:
Patients with cancer need coordinated care for both treatment and concurrent health conditions. This requires collaboration among specialists when using telemedicine services, emphasizing the importance of care continuity.
Objective:
This study examines the impact of an intervention facilitating this collaboration using an additional shared video consultation involving oncologist, general practitioners, and patients with cancer compared to usual care on the patients’ perceived coordination of care.
Methods:
This study describes the primary outcomes from a 7 month follow up of patients in The Partnership Project (PSP)- a randomized clinical trial. Questionnaires were completed for both groups at baseline, and 7 months to assess the primary outcome, “global assessment of inter-sectorial cooperation,” from the Danish questionnaire “Patients’ attitude to the health care service”. The questionnaire also included two single items and five index scales, examining patient’s attitude toward cooperation in the health care system. Change in perceived global coordination from baseline to 7 months was compared between intention-to-treat groups using Generalized Estimating Equations (GEE) in a linear regression model.
Results:
A total of 278 participants were randomized with 1:1 allocation. 210 patients completed the questionnaire at baseline, while 118 responded at 7-month follow-up. The estimated difference in the primary outcome between usual care (-0.13, 95% CI: -0.38 to 0.12) and intervention (0.11, 95% CI: -0.11 to 0.34) was 0.24 (95% CI: -0.09;0.58) and not statistically significant (P-value= 0.155).
Conclusions:
Our study showed a high global assessment of inter-sectoral cooperation among patients with cancer. We found that the shared video consultation model did not lead to statistically significant difference in perceived global coordination change from baseline to follow-up between control and intervention group. Further exploration of specific aspect of care coordination may provide additional insights into areas for improvement in this innovative health care model. Clinical Trial: (NCT02716168), registered 03 March 2016
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