Rapid Fire Best of the Best Poster Oral Clinical Oncology Society of Australia Annual Scientific Meeting 2022

Telehealth use in cancer clinical trials during the COVID-19 pandemic (#120)

Melissa Austen 1 , Carolyn Der Vartanian 1 , Janessa Catto 1 , Vivienne Milch 1 2 , Sophia Paynter 1 , Emma Thomas 3 4 , Anthony C Smith 3 4 5 , Anna Boltong 1 6
  1. Cancer Australia, Strawberry Hills, NSW, Australia
  2. The University of Notre Dame Australia, Sydney, NSW, Australia
  3. Centre for Online Health, The University of Queensland, Brisbane, Qld, Australia
  4. Centre for Health Services Research, The University of Queensland, Brisbane, Qld, Australia
  5. Centre for Innovative Medical Technology, University of Southern Denmark, Denmark
  6. Kirby Institute, UNSW Medicine, The University of New South Wales, Sydney, NSW, Austraila

Aims

Cancer clinical trials have traditionally been conducted in-person. The COVID-19 pandemic accelerated changes across the entire cancer care continuum, including in clinical trials and teletrials. This study aimed to investigate how telehealth was used in cancer clinical trials during the pandemic, including benefits and barriers to use; and to identify how telehealth can be further enhanced and routinely integrated into cancer clinical trials in Australia.

Methods

A mixed methods approach was used, involving a scoping review of literature, surveys of staff from 14 multi-site Collaborative Cancer Clinical Trial Groups across Australia (n=98), and qualitative interviews with trial administrators and clinicians (n=21).

Results

The literature showed exponential increase in the use of telehealth in cancer trials internationally during the pandemic. Most study participants agreed that telehealth enabled continuation of trials which may have otherwise been postponed or terminated due to the pandemic. Participants indicated strong willingness to use telehealth for certain aspects of trials due to benefits including improved efficiencies in recruitment and consent processes; improved equity of access for people in rural and regional areas; expedited ethics reviews; convenience of e-prescriptions; and reduced need for travel. Barriers included technology issues; inequitable access; activities requiring in-person attendance; regulatory obstacles; remote site capabilities; data quality and security issues; lack of training; and resistance to change. 

Conclusion

The rapid shift to telehealth models during the pandemic was viewed positively by participants, with increased innovation and efficiencies. Many, but not all, aspects of cancer clinical trials are appropriate to be delivered via telehealth. Telehealth is most appropriate in later phase trials; for oral (not IV) drugs; and for activities not requiring physical examinations or invasive interventions. Participants preferred hybrid models which include both telehealth and in-person methods, tailored by cancer type, interventions, and patient preferences; supported by clear guidelines and staff training.