Transitioning Care: Perspectives of Older Women With Early Breast Cancer on Current Telemedicine Modalities

Study Overview
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Brief Summary
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Explosive growth in the use of telemedicine (video or telephone visits) has followed the onset of the coronavirus disease 2019 (COVID-19) pandemic in order to meet healthcare needs while avoiding unnecessary exposure risks in ambulatory care spaces. Accordingly, in March 2020, the Centers for Medicare & Medicaid Services expanded reimbursement for telemedicine visits to equal that of in-person services. The policy and infrastructure that enabled this emergency transition is laying the groundwork for enduring expansion of elective telemedicine, a technology that could significantly decrease the burden of medical care in older patients with cancer. To benefit from telehealth, patients must have a certain level of knowledge and capacity to engage with technology, which can be a challenge for some older adults because of inexperience, access, and disability. As cancer is mainly a disease of older adults, with a median age of 65 at diagnosis for most cancer types, this is a significant limitation on the utility of telemedicine in oncology. The goal of our study is to better understand older breast cancer patients' experiences with telephone and video telemedicine with regard to visit convenience, completeness, and interpersonal satisfaction through semi-structured interviews with patients.

Detailed Description
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Methods: 30 participants will be consented in this study. 20 will have participated in video telemedicine appointments with their treating breast cancer oncologists, and 10 will have used telephone. Semi-structured interviews lasting no more than 30 minutes will be conducted to ascertain the participant's (1) reason for choosing a certain telemedicine modality, (2) perception of telemedicine visit convenience, completeness, and interpersonal satisfaction compared to in-person visits, and (3) use of peripheral virtual support from healthcare team, such as messaging in MyChart. After the interview has been conducted, the patient will be asked complete the patient-reported portion of the Geriatric Assessment (GA) either through an internet link, or verbally with the research staff reading the questions and recording the answers. Data pertaining to the participant's breast cancer diagnosis and treatment will be extracted from Epic@UNC.

Official Title
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Transitioning Care: Perspectives of Older Women With Early Breast Cancer on Current Telemedicine Modalities

Conditions
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Breast Cancer Female, Breast Cancer

Intervention / Treatment
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* Behavioral: Semistructured Interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: female age 65 or older diagnosed with early breast cancer (Stage I-III) completed primary treatment (surgery, chemotherapy, radiation treatment) received in-person outpatient care at North Caroline Cancer Hospital before transitioning to telemedicine after March 2020 providing written informed consent able to understand and speak English. Exclusion Criteria: Patients who do not meet the inclusion criteria stated above will be excluded. There will be no further exclusion criteria.

Ages Eligible for Study
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Minimum Age: 65 Years
Maximum Age: 110 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Video Telemedicine<br>20 participants will have used video telemedicine for appointments with their treating oncologist. | Behavioral: Semistructured Interview<br>* Patients with breast cancer (Stage I-III) will be interviewed about their experiences of telemedicine.<br>|
| Telephone Telemedicine<br>10 participants will have used telephone telemedicine for appointments with their treating oncologist. | Behavioral: Semistructured Interview<br>* Patients with breast cancer (Stage I-III) will be interviewed about their experiences of telemedicine.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Qualitative Summaries of Interviews about Participant Experience with Telemedicine | Qualitative Summaries derived from content analysis of semi-structured interview transcripts around themes and sub themes of convenience, psychosocial experience, baseline comfort with technology, preference for telephone vs. video visits, and desire to continue using telemedicine in the future. | 3 months post study start | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Telemedicine