Telehealth Survivorship Programs for Head and Neck Cancer Patients Shown Feasible and Cost-Effective

CLINICAL QUESTION

What is the feasibility and cost of telehealth head and neck cancer (HNC) survivorship care?

BOTTOM LINE

Although telehealth survivorship programs are feasible and cost-effective and associated with improved patient outcomes, they might not be ideal for every patient.

BACKGROUND: Patients with HNC face a plethora of long-term, treatment-related functional deficits, often requiring long-term support and management of symptoms. Survivorship care aims to address the medical, psychosocial, interpersonal, financial, and functional consequences of cancer and its therapies. This healthcare domain might particularly benefit from the integration of the telehealth model.

STUDY DESIGN: Literature review.

SETTING: Department of Otorhinolar-yngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia.

SYNOPSIS: Researchers identified feasibility studies on telehealth models for HNC survivorship care published between 2005 and 2021. Criteria included programs that provided specific and quantitative feasibility outcome measures. Thirty-eight studies were included for analysis. Primary and secondary outcomes were intervention feasibility (including enrollment, patient and provider satisfaction, adherence, and attrition) and cost-effectiveness, respectively. For the telehealth model, the patient enrollment average was 48.8%; weighted mean patient satisfaction rate 65.6%; average adherence rate 70.7%; and mean attrition rate 14.9%. Usability ratings were high at 94.6%. Studies with cost analysis (n=5) found telehealth models of care to result in a $642.30 savings per patient and reduced work time savings of seven days per visit, on average. Authors conclude that, although telehealth survivorship programs are feasible, cost-effective, and associated with improved outcomes, existing and persisting inequities in access and other barriers in use of technology among patients with cancer mean that they might not be ideal for every patient. They note the need for an evaluation system to understand such factors and to help inform clinicians. Study limitations included divergences in study design, methodology, type of intervention, and outcomes assessed that made it difficult to summarize findings.

CITATION: De Ravin E, Armache M, Campbell F, et al. Feasibility and cost of telehealth head and neck cancer survivorship care: a systematic review. Otolaryngol Head Neck Surg. 2023;168:1312–1323.