UTILIZATION OF TELEMEDICINE IN CANCER PATIENTS: CONTEMPORARY ANALYSIS OF THE NATIONAL HEALTH INTERVIEW SURVEY DURING AND POST COVID-19 ERA

Abstract

Introduction

During and after COVID-19 pandemic, the demand for telemedicine has skyrocketed. Evidence suggests that high-quality Uro-oncological care can be delivered by means of telemedicine, with some caveats. Against this backdrop, we sought to analyze the use of telemedicine among cancers, hypothesizing that its use may be higher for certain oncological conditions relative to others.

Methods

We conducted a cross-sectional study on cancer patients using data starting from July 2020 using in the National Health Interview Survey (NHIS). We utilized an affirmative answer to “Have you EVER been told by a doctor or other health professional that you had Cancer or a malignancy of any kind?” to identify patients with cancer history. We used the question “In the past 12 months, have you had an appointment with a doctor, nurse, or other health professional by video or by phone?” to identify telemedicine recipients. Survey-weighted multivariable Poisson regression analysis adjusted for potential confounders was conducted to estimate risk ratios (RR) for receipt of telemedicine, and a two-way interaction between currently receiving treatment and cancer type was assessed for any effect modification.

Results

We identified 7,784 individuals with a cancer history, representing a weighted population of 40 million. The prevalence of telemedicine utilization was 47.8%. Relative to breast cancer, we found that PCa was a significant predictor of receipt of telemedicine (RR: 1.39, 95% CI: [1.06-1.81], P= 0.02), (see Table). A significant interaction was found between those currently receiving treatment for cancer and cancer type P_int<0.01; marginal probability analysis showed patients currently receiving PCa treatment were more likely to receive telemedicine, with an adjusted risk difference of 0.18, (95% CI[0.01-0.35], P=0.04).

Conclusions

Our study suggests that telemedicine appointments were widely used among cancer survivors after July 2020, with PCa survivors more likely to use telemedicine compared to other malignancies. Such findings may point to wider adoption of telemedicine among urologists, as suggested by other studies, or that PCa care lends itself better to telemedicine, compared to other malignancies. Future studies should focus on understanding the dynamics of such patient- and provider-level factors.