Telemedicine in Cancer Palliative Care: a Legacy of the Pandemic

Authors

  • Cristhiane da Silva Pinto Instituto Nacional de Câncer, Unidade de Cuidados Paliativos, Hospital do Câncer IV. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-2349-6681
  • Alessandra Zanei Borsatto Instituto Nacional de Câncer, Unidade de Cuidados Paliativos, Hospital do Câncer IV. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0003-4608-0918
  • Danielle Copello Vaz Instituto Nacional de Câncer, Unidade de Cuidados Paliativos, Hospital do Câncer IV. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-2536-2492
  • Simone Garruth dos Santos Machado Sampaio Instituto Nacional de Câncer, Unidade de Cuidados Paliativos, Hospital do Câncer IV. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0001-5537-7399
  • Livia Costa de Oliveira Instituto Nacional de Câncer, Unidade de Cuidados Paliativos, Hospital do Câncer IV. Rio de Janeiro (RJ), Brasil. https://orcid.org/0000-0002-5052-1846

DOI:

https://doi.org/10.32635/2176-9745.RBC.2023v69n1.2698

Keywords:

palliative care, ambulatory care, telemedicine

Abstract

Introduction: Telemedicine can be a useful tool for monitoring patients in palliative care, especially in the context of the COVID-19 pandemic. Objective: To describe the use of telemedicine for outpatients followed up in an Oncological Palliative Care unit in a national reference hospital. Method: A retrospective analysis of medical teleconsultations performed between April 2020 and February 2021 to outpatients followed up at the unit. Demographic and clinical data of patients, telehealth characteristics and medical management were analyzed. A subjective evaluation was carried out with the professionals responsible for the calls. Results: 1,645 medical teleconsultations were carried out to 470 patients with a mean age of 62 (54-73) years, mostly females (n=258; 54.9%) and with Karnofsky Performance Status estimated at 40% or higher (n=423; 90.0%) at the time of the first remote contact. Most of the teleconsultations were carried out (n=928; 56.4%) to monitor the burden of symptoms between in-person consultations. Of these, 612 (relative frequency=65.9%) controlled the symptom in the subsequent telehealth. The most prevalent complaint was pain (n=303; relative frequency=32.7%) followed by flu-like symptoms (n=108; relative frequency=11.6%). Of the clinical conducts planned, the most prevalent (n=921; 56.0%) was only for the person responsible to pick up the medications, the patient did not need to go to the hospital. Conclusion: Telemedicine proved to be useful in monitoring symptoms of patients with advanced cancer and it allowed patients and caregivers to stay in their homes, reducing displacement and, consequently, the risk of contagion by COVID-19.

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References

Hancock S, Preston N, Jones H, et al. Telehealth in palliative care is being described but not evaluated: a systematic review. BMC Palliat Care. 2019;18(1):114. doi: https://doi.org/10.1186/s12904-019-0495-5 DOI: https://doi.org/10.1186/s12904-019-0495-5

World Health Organization. Geneva: WHO; c2020. WHO Director-General’s opening remarks at the media briefing on COVID-19; 2020 Mar 11 [cited 2020 Apr 12]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

Calton B, Abedini N, Fratkin M. Telemedicine in the time of coronavirus. J Pain Symptom Manage. 2020;60(1):e12-e14. doi: https://doi.org/10.1016/j.jpainsymman.2020.03.019 DOI: https://doi.org/10.1016/j.jpainsymman.2020.03.019

Academia Nacional de Cuidados Paliativos. Posicionamento da Academia Nacional de Cuidados Paliativos sobre covid-19 [Internet]. São Paulo: ANCP; [2020] [acesso 2020 abr 20]. Disponível em: https://www.dropbox.com/s/g77qi6xk2jc8rky/FINAL_ANCP_Ebook_cuidados_COVID-19.pdf?dl=0

Wakan GK, Montgomery JR, Biesterveld BE, et al. Not dying alone - modern compassionate care in the covid-19 pandemic. N Engl J Med. 2020;382(24):e88. doi: https://doi.org/10.1056/NEJMp2007781 DOI: https://doi.org/10.1056/NEJMp2007781

Grange ES, Neil EJ, Stoffel M, et al. Responding to COVID-19: the UW medicine information technology services experience. Appl Clin Inform. 2020;11(2):265-75. doi: https://doi.org/10.1055/s-0040-1709715 DOI: https://doi.org/10.1055/s-0040-1709715

Ministério da Saúde (BR). Portaria nº 467, de 20 de março de 2020. Dispõe, em caráter excepcional e temporário, sobre as ações de Telemedicina, com o objetivo de regulamentar e operacionalizar as medidas de enfrentamento da emergência de saúde pública de importância internacional previstas no art. 3º da Lei nº 13.979, de 6 de fevereiro de 2020, decorrente da epidemia de COVID-19 [Internet]. Diário Oficial da União, Brasília, DF; 2020 mar 23 [acesso 2020 abr 7]; Edição 56-B; Seção I – Extra:1. Disponível em: http://www.in.gov.br/en/web/dou/-/portaria-n-467-de-20-de-marco-de-2020-249312996

Conselho Federal de Medicina (BR). Ofício CFM nº 1756/2020 – COJUR [Internet]. Brasília, DF: CFM; 2020 [acesso 2020 abr 10]. Disponível em: http://portal.cfm.org.br/images/PDF/2020_oficio_telemedicina.pdf

Conselho Federal de Enfermagem (BR). Resolução nº 634, de 26 de março de 2020. Autoriza e normatiza, "ad referendum" do Plenário do Cofen, a teleconsulta de enfermagem como forma de combate à pandemia provocada pelo novo coronavírus (Sars-Cov-2), mediante consultas, esclarecimentos, encaminhamentos e orientações com uso de meios tecnológicos, e dá outras providências [Internet]. Diário Oficial da União, Brasília, DF; 2020 mar 27 [acesso 2020 abr 10]; Edição 60; Seção 1:117. Disponível em: https://www.in.gov.br/web/dou/-/resolucao-n-634-de-26-de-marco-de-2020-249995879

Pinto CS, Borsatto AZ, Vaz DC, et al. Teleatendimento ambulatorial em cuidados paliativos oncológicos: quebrando paradigmas e transformando a realidade atual. Rev Bras Cancerol. 2021;67(3):e-071732 doi: https://doi.org/10.32635/2176-9745.RBC.2021v67n3.1732 DOI: https://doi.org/10.32635/2176-9745.RBC.2021v67n3.1732

Freitas R, Oliveira LAF, Rosa KSC, et al. Cuidados paliativos em pacientes com câncer avançado e covid-19. Rev Bras Cancerol. 2020;66(TemaAtual):e-1077. doi: https://doi.org/10.32635/2176-9745.RBC.2020v66nTemaAtual.1077 DOI: https://doi.org/10.32635/2176-9745.RBC.2020v66nTemaAtual.1077

Sampaio SGSM, Dias AM, Freitas R. Orientações do serviço médico de uma unidade de referência em cuidados paliativos oncológicos frente à pandemia de covid-19. Rev Bras Cancerol. 2020;66(TemaAtual):e-1058. doi: https://doi.org/10.32635/2176-9745.RBC.2020v66nTemaAtual.1058 DOI: https://doi.org/10.32635/2176-9745.RBC.2020v66nTemaAtual.1058

Karnofsky DA, Burchenal JH. The clinical evaluation of chemotherapeutic agents in cancer. In: MacLeod CM, editor. Evaluation of chemotherapeutic agents. New York: Columbia Univ Press; 1949. p.191-205.

Conselho Nacional de Saúde (BR). Resolução nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. Diário Oficial da União, Brasília, DF. 2013 jun 13; Seção 1:59.

Hennemann-Krause L, Lopes AJ, Araújo JA, et al. The assessment of telemedicine to support outpatient palliative care in advanced cancer. Palliat Support Care. 2015;13(4):1025-30. doi: https://doi.org/10.1017/S147895151400100X DOI: https://doi.org/10.1017/S147895151400100X

Worster B, Swartz K. Telemedicine and palliative care: an increasing role in supportive oncology. Curr Oncol Rep. 2017;19(6):37. doi: https://doi.org/10.1007/s11912-017-0600-y DOI: https://doi.org/10.1007/s11912-017-0600-y

Chávarri-Guerra Y, Ramos-López WA, Covarrubias-Gómez A, et al. Providing supportive and palliative care using telemedicine for patients with advanced cancer during the covid-19 pandemic in Mexico. Oncologist. 2021;26(3):e512-e5. doi: https://doi.org/10.1002/onco.13568 DOI: https://doi.org/10.1002/onco.13568

Silva MD, Schack EE. Outpatient palliative care practice for cancer patients during covid-19 pandemic: benefits and barriers of using telemedicine. Am J Hosp Palliat Care. 2021;38(7):842-4. doi: https://doi.org/10.1177/1049909121997358 DOI: https://doi.org/10.1177/1049909121997358

Salem R, El Zakhem A, Gharamti A, et al. Palliative care via telemedicine: a qualitative study of caregiver and provider perceptions. J Palliat Med. 2020;23(12):1594-8. doi: https://doi.org/10.1089/jpm.2020.0002 DOI: https://doi.org/10.1089/jpm.2020.0002

Tasneem S, Kim A, Bagheri A, et al. Telemedicine video visits for patients receiving palliative care: a qualitative study. Am J Hosp Palliat Care. 2019;36(9):789-94. doi: https://doi.org/10.1177/1049909119846843 DOI: https://doi.org/10.1177/1049909119846843

Jess M, Timm H, Dieperink KB. Video consultations in palliative care: a systematic integrative review. Palliat Med. 2019;33(8):942-58. doi: https://doi.org/10.1177/0269216319854938 DOI: https://doi.org/10.1177/0269216319854938

Biswas S, Adhikari SD, Gupta N, et al. Smartphone-based telemedicine service at palliative care unit during nationwide lockdown: our initial experience at a tertiary care cancer hospital. Indian J Palliat Care. 2020;26(Suppl 1):S31-S35. doi: https://doi.org/10.4103/IJPC.IJPC_161_20 DOI: https://doi.org/10.4103/IJPC.IJPC_161_20

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Published

2023-01-31

How to Cite

1.
Pinto C da S, Borsatto AZ, Vaz DC, Sampaio SG dos SM, Oliveira LC de. Telemedicine in Cancer Palliative Care: a Legacy of the Pandemic. Rev. Bras. Cancerol. [Internet]. 2023 Jan. 31 [cited 2024 May 21];69(1):e-142698. Available from: https://rbc.inca.gov.br/index.php/revista/article/view/2698

Issue

Vol. 69 No. 1 (2023): Jan./Feb./Mar.

Section

ORIGINAL ARTICLE

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