How feasible and cost-effective is telehealth survivorship care for head and neck cancer (HNC) patients?
BOTTOM LINE
Telehealth survivorship programs are feasible, cost-effective, and associated with improved patient outcomes but are not ideal for every patient.
BACKGROUND: There are more than 400,000 HNC survivors in the United States who face ongoing treatment-related side effects that adversely affect their quality of life (QOL) and they often require long-term symptom management through frequent multidisciplinary follow-up visits.
STUDY DESIGN: Systematic review.
SETTING: Department of Otorhinolaryngology–Head and Neck Surgery, University of Pennsylvania, Philadelphia, Penn.
SYNOPSIS: Researchers examined feasibility studies from years 2005–2021 of telehealth survivorship program interventions for HNC patients with quantitative feasibility outcome measures. Thirty-eight studies representing 2,085 patients were included. Programs were sorted into three groups: favors telehealth; no difference/no comparison or control group; and favors control. Authors used five main feasibility outcomes (enrollment, patient satisfaction, provider satisfaction, adherence, and attrition), cost-effectiveness, and treatment-related outcome. Results suggested that telehealth programs focused on HNC survivorship are cost-effective and have acceptable enrollment rates (48.8%), adequate adherence (70.7%) and patient satisfaction (65.6%), and high usability ratings (94.6%). Studies reported QOL assessment improvement under telehealth models that were similar or superior to standard models of care. Survivorship care telehealth models were associated with improvement in cancer-specific symptoms such as radiation-related fibrosis and cancer-related fatigue, pain, appetite loss, and dependence.
CITATION: De Ravin E, Armache M, Campbell F, et al. Feasibility and cost of telehealth head and neck cancer survivorship case: a systematic review. Otolaryngol Head Neck Surg. 2023;168:1312–1323.