Feasibility and Cost of Telehealth Head and Neck Cancer Survivorship Care: A Systematic Review

• Published in: Otolaryngology-head and neck surgery 2023-06, Vol.168 (6), p.1312-1323
• Main Authors: De Ravin, Emma, Armache, Maria, Campbell, Frank, Rising, Kristin L., Worster, Brooke, Handley, Nathan R., Fundakowski, Christopher E., Cognetti, David M., Mady, Leila J.
• Format: Article
• Language: English
• Subjects: Cancer Survivors; Feasibility Studies; head and neck cancer; Head and Neck Neoplasms; Humans; patient satisfaction; Survivorship; telehealth; Telemedicine
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1002/ohn.213

Objective Evaluate the feasibility and cost‐effectiveness of telehealth head and neck cancer (HNC) survivorship care. Data Sources Ovid MEDLINE, Embase, Scopus, CINAHL. Review Methods A systematic search for peer‐reviewed feasibility studies on telehealth models for HNC survivorship care published between 2005 and 2021 was conducted using the terms “head and neck cancer” and “telehealth” and their synonyms. Inclusion criteria were studies on telehealth survivorship program interventions for HNC patients with quantitative feasibility outcome measures (eg, enrollment, retention, attrition/dropout rate, adherence/task completion rate, patient satisfaction, cost). Results Thirty‐eight studies out of 1557 identified met inclusion criteria and were included for analysis. Feasibility outcomes evaluated were enrollment and attrition rates, adherence/task completion rates, patient satisfaction, and user feedback surveys in different survivorship domains. Patient enrollment ranged from 20.8% to 85.7%, while attrition ranged from 7% to 47.7%. Overall, adherence was 30.2% higher in the intervention group than in the control group (46.8% vs 16.6%). Studies with cost analysis found telehealth models of care to be statistically significantly less expensive and more cost‐efficient than the standard model of care, with a $642.30 saving per patient (n = 3). Telehealth models also substantially reduced work time saving per visit (on average, 7 days per visit). Conclusion While telehealth survivorship programs are feasible and cost‐effective and are associated with improved patient outcomes, they might not be ideal for every patient. Further investigations are needed to understand the role of telehealth in survivorship care, given the variability in study design, reporting, measures, and methodological quality.