Challenges of Cross-Sectoral Video Consultation in Cancer Care on Patients' Perceived Coordination: 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 aimed to explore the effects of cross-sectorial video consultation involving oncologists, general practitioners, and patients with cancer on patients' perceived coordination of care, compared with usual care.

Methods: This study describes the primary outcomes from a 7-month follow-up of patients in the Partnership Project, a randomized clinical trial. Patients in the intervention group were randomized to receive a "partnership consultation," a shared video consultation with an oncologist, general practitioners, and the patient, in addition to their usual care. 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 2 single items and 5 index scales, examining patients' 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 in a linear regression model.

Results: A total of 278 participants were randomized with 1:1 allocation, with 80 patients receiving the intervention. Further, 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 to 0.58) and not statistically significant (P=.15).

Conclusions: Low rates of intervention completion and high levels of missing data compromised the interpretability of our study. While we observed a high level of global assessment of coordination, the estimated intervention effect was smaller than anticipated, with no significant difference in perceived coordination between control and intervention groups. Future studies should explore strategies like patient incentives to increase response rate and improve the evaluation of this innovative health care model.