Clinician perceptions of asynchronous care for patients with ovarian cancer on PARP inhibitor therapy.

Abstract

Asynchronous care is an alternative model of care involving information transmission without a simultaneous interaction between people. This study aimed to understand clinician perspectives about providing asynchronous care to patients with ovarian cancer who are clinically stable and receiving poly(adenosine diphosphate-ribose) polymerase inhibitor (PARPi) maintenance therapy at a large academic teaching hospital. The Theoretical Domains Framework (TDF) was used to undertake this study. Interviews were conducted with oncologists, physician assistants, and nurses who actively manage this patient population. Data were analyzed according to TDF domains to generate themes and understand supports, barriers, and buy-in related to this model of care. Overall, 73% of the 15 clinicians (50% of the oncologists) participating in this study were willing to provide asynchronous care to patients on PARPi who were clinically stable. Several themes emerged representing considerations for moving forward with this model of care, including selecting the ideal patients, streamlined access to information, safe and effective escalations, perceived acceptability of the asynchronous model by clinicians, reimbursement, and an opportunity and willingness to innovate. Participants recognized the potential benefits of an asynchronous care model for patients on PARPi therapy who are clinically stable and the opportunity to innovate while optimizing the use of limited clinic resources. Continued work toward discovery and implementation of an asynchronous care model should account for findings uncovered by application of the TDF.