Evaluating if Pre-Treatment Education Is Meeting the Needs of All Radiation Therapy Patients

Abstract

Purpose/Aim

Pre-treatment radiation therapy education has been shown to support patients, reduce their anxiety and even improve their satisfaction with overall cancer care. Numerous approaches have been tested including self-directed learning with written pamphlets or videos, or 1-on-1 with a Radiation Therapist in-person or videoconferencing. As telephone-based patient education has been implemented since the COVID-19 pandemic, the aim was to evaluate if radiation therapy patients’ information needs are being achieved.

Methods/Process

As part of standard care, all patients received a 30-minute telephone consultation with a Radiation Therapist prior to their CT-simulation to review what to expect during their specific treatment course. For this prospective study approved as quality improvement, at CT-simulation patients were offered a questionnaire about the telephone consultation with implied consent for those who completed it. The 21-item questionnaire was designed to capture patients’ satisfaction with the information they received over the telephone (Likert-scale, 7 items), their preferences (e.g. timing/scheduling, in-person vs virtual modalities, mandatory vs optional) and demographic questions. Data was analysed with descriptive statistics and relationships between subgroups were explored with post-hoc tests (Chi-square, T-test, ANOVA).

Results or Benefits/Challenges

Over two months 312 patients returned the survey, of which 278 were completed and included in this analysis. Overall mean Likert-scale scores were 4.10 (standard deviation 0.75) indicating patients agreed/strongly agreed the session help them prepare, new and sufficient information was provided, and they were comfortable speaking on the phone. Majority responded that the 30 min length (90.0%) prior to CT-simulation (60.4%) was optimal and that it should be mandatory (65.4%). Regarding modalities, 61.4% preferred the telephone (vs in-person, videoconferencing, etc.), although 52.5% indicated they would like additional information in short digital videos. There were consistent trends for those with lower education levels to report lower satisfaction, and they were significantly less comfortable receiving information over the telephone (p< 0.05). More first-time patients versus those returning for re-irradiation indicated the session should be mandatory (71.1% vs 52.2%, p= 0.011), instead of optional. No other significant differences were observed by subgroup based on cancer type, age, gender, or race/ethnicity (p > 0.05).

Conclusions/Impact

Patients reported overall that a pre-treatment telephone consultation with a Radiation Therapist provided them with new information that helped them prepare for radiation therapy. Results also indicate that a sizable minority of patients may benefit from tailored approaches for their level of comprehension, prior medical experience and preferred learning styles. Optimally resources would be directed to radiation therapy patients with unmet needs in the future