Ensuring quality of care for oncology patients is a major challenge in light of the COVID 19 pandemic. In particular, non-essential therapies, which can be of great importance for the quality of life, are often forgotten. This is something the Society for Integrative Oncology (SIO) has been working hard on and has developed recommendations for telemedicine care.
While absolutely necessary medical appointments continued to be attended, complementary therapeutic services for cancer patients have been very limited in recent months due to the pandemic. And this in a time, which brought anyway numerous additional loads with itself. The demand for such services is therefore likely to have increased. Now, a specially formed working group of the SIO (Society for Integrative Oncology) has issued recommendations on how to ensure the care of oncology patients through complementary telemedicine services. The conclusion: telemedicine should never completely replace a personal visit to the doctor. And yet, it offers many underutilized opportunities to improve continuity of care.
Sophisticated process
The task force devised a four-step process to produce the catalog of recommendations, which was released in April of this year. First, a literature review was conducted from which key elements of integrative oncology care were identified. Then, SIO members developed a questionnaire about potential challenges and strategies that was sent to 54 integrative oncology experts in 19 countries. Based on the responses and the literature review, the most pressing challenges were finally defined by the working group and possible practical approaches were evaluated. The focus was particularly on manual, art and movement therapies, acupuncture, mind-body treatments and herbal therapies – although the recommendations are of interest beyond these specific areas.
Ten challenges in sight
In total, the experts analyzed ten challenges of a telemedical consultation in detail and developed recommendations for overcoming them (Tab. 1). In principle, these recommendations should be helpful for every telemedical consultation. The working group attaches great importance to the attitude towards alternative forms of consultation – namely that of patients and relatives, as well as that of practitioners. Any skepticism must be considered and addressed, according to the experts. In addition, it is important to prepare telemedicine treatments well. Among other things, legal and ethical issues, such as privacy and data protection, should be clarified before introduction. More concretely, this also includes an agreement with the patient as to whether the session should be recorded. In principle, the expectations of the physician and the patient should be discussed at the beginning of the consultation in order to clearly define the goals. According to the expert group, this is even more important in a digital environment, which is less tangible than a face-to-face meeting, than in traditional consultation. In general, telemedicine does not seem to save time. Finally, more frequent comprehension problems and a time-consuming start-up period are sometimes compounded by technical difficulties. Here it is recommended to speak slowly and understandably as well as to include caring persons in the telemedical consultation.
Despite the expense and widespread skepticism, the authors agree that telemedicine is worthwhile – especially in the current climate – and still offers much room for improvement. However, a complete replacement of classic consultations should not be aimed for. In particular, patients with limited access to integrative oncology services due to geographic, financial, physical, or social issues could increasingly benefit from targeted and well-prepared use of telemedicine in the future. With or without a pandemic.
Source: Ben-Arye E, et al: The Society for Integrative Oncology Practice Recommendations for online consultation and treatment during the COVID-19 pandemic. Supportive Care in Cancer. 2021. doi: 10.1007/s00520-021-06205-w. Epub ahead of print.
InFo ONCOLOGY & HEMATOLOGY 2021; 9(4): 48 (published 9/20-21, ahead of print).
