Patterns of telehealth use in newly diagnosed prostate cancer patients.

Abstract

Objectives: To characterize the use of Telehealth in prostate cancer management at a national-level in the United States.

Methods: We used a population-level database (MarketScan Commercial Claims and Medicare Supplemental Database, Merative, Ann Arbor, MI) of prostate cancer patients diagnosed with localized prostate cancer from 2017 through 2022 with commercial or Medicare coverage to evaluate variation in telehealth use based on patient factors and place of residence (defined by metropolitan statistical area).

Results: We identified 33,236 patients with localized prostate cancer. About 8,574 men (25.8%) had any telehealth usage in the 6 months before or 12 months after diagnosis. 5,483 (16.5%) patients had ≥1 cancer-specific telehealth visit within 12 months after diagnosis. Of these, 4,896 patients (89.3%) reside in a metropolitan statistical area. On multivariable logistic regression analysis, younger vs. older patients, health plan, residing in a metropolitan statistical area, living outside of the Southern US, and year of index biopsy were significantly associated with the receipt of prostate cancer-related telehealth. Telehealth use remarkably increased in early 2020 with decline in late 2020 then remained stably above pre-COVID levels throughout 2021 to 2022.

Conclusions: We report the first analysis of telehealth use by men with localized prostate cancer nationwide. Telehealth adoption was associated with year of index biopsy, numerous patient factors, and residing in a large metropolitan area. This work helps clarify geographic patterns of implementation and factors associated with access to telehealth prostate cancer care since COVID-19, which is timely given upcoming legislative decisions to be made surrounding continued coverage flexibilities.