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Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of a pilot project

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Abstract

Purpose

Palliative care (PC) and palliative radiotherapy (RT) consultation are integral to the care of patients with advanced cancer. These services are not universally available in rural areas, and travel to urban centers to access them can be burdensome for patients and families. The objectives of our study were to assess the feasibility of using videoconferencing to provide specialist multidisciplinary PC and palliative RT consultation to cancer patients in rural areas and to explore symptom, cost, and satisfaction outcomes.

Methods

The Virtual Pain and Symptom Control and Palliative Radiotherapy Clinic was piloted from January 2008 to March 2011. Cancer patients in rural northern Alberta attended local telehealth facilities, accompanied by nurses trained in symptom assessment. The multidisciplinary team at the Cross Cancer Institute in Edmonton was linked by videoconference. Team recommendations were sent to the patients’ family physicians. Data were collected on referral, clinical, and consultation characteristics and symptom, cost, and satisfaction outcomes.

Results

Forty-four initial consultation and 28 follow-up visits took place. Mean Edmonton Symptom Assessment Scale scores for anxiety and appetite were statistically significantly improved at the first follow-up visit (p < 0.01 and p = 0.03, respectively). Average per visit savings for patients seen by telehealth versus attending the CCI were 471.13 km, 7.96 hours, and Cdn $192.71, respectively. Patients and referring physicians indicated a high degree of satisfaction with the clinic.

Conclusion

Delivery of specialist multidisciplinary PC consultation by videoconferencing is feasible, may improve symptoms, results in cost savings to patients and families, and is satisfactory to users.

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Acknowledgments

The authors would like to acknowledge the invaluable contributions of members of the Virtual Clinic Pilot Project Team, drawn from Alberta Health Services Cancer Care (Cross Cancer Institute and Community Oncology), Seniors Health (North Zone), and Telehealth. This study was funded by Alberta Health and Wellness.

Conflict of interest

There are no conflicts of interest to declare. The authors have full control of all primary data which may be reviewed by the journal if requested.

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Authors and Affiliations

  1. Department of Symptom Control and Palliative Care, Cross Cancer Institute, Edmonton, Alberta, Canada

    Sharon M. Watanabe & Patricia Borgersen

  2. Division of Palliative Care Medicine, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada

    Sharon M. Watanabe & Konrad Fassbender

  3. Department of Radiation Oncology, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada

    Alysa Fairchild & Edith Pituskin

  4. Cross Cancer Institute, Edmonton, Alberta, Canada

    John Hanson

Authors
  1. Sharon M. Watanabe
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  2. Alysa Fairchild
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  3. Edith Pituskin
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  4. Patricia Borgersen
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  5. John Hanson
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  6. Konrad Fassbender
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Corresponding author

Correspondence to Alysa Fairchild.

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Watanabe, S.M., Fairchild, A., Pituskin, E. et al. Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: report of a pilot project. Support Care Cancer 21, 1201–1207 (2013). https://doi.org/10.1007/s00520-012-1649-7

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  • DOI: https://doi.org/10.1007/s00520-012-1649-7

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