High-quality cancer care can be safely provided at rural centres via a telehealth approach, using supervision by urban-based doctors, new research published in the Medical Journal of Australia shows.
Associate Professor Sabe Sabesan, Senior Staff Specialist and Director of Medical Oncology at the Townsville Cancer Centre (TCC), and his co-authors from the TCC, Townsville Hospital and James Cook University compared the chemotherapy regimen delivered directly to cancer patients at the TCC and that received by cancer patients at Mt Isa Hospital via a teleoncology model of delivery.
Over the 5-year study period, 89 patients received a total of 626 cycles of various chemotherapy treatments in Mount Isa, and 117 patients received a total of 799 cycles of chemotherapy at TCC. Medical oncologists assessed rural patients for fitness to undergo chemotherapy and used video- conferencing to make decisions about admitted inpatients. This assessment was supported by rurally based doctors and nurses during telehealth consultations. Chemotherapy-proficient nurses administered chemotherapy agents prescribed by TCC-based medical oncologists.
The researchers found that "there were no statistically significant differences in dose intensities between sites, regardless of treatment intent."
Further, "no site differences in ... rates of serious adverse events were detected".
"Our study is the first to show that many types of chemotherapy can be administered in rural centres, without compromising safety and quality, by teleoncology models of care", the researchers concluded.
"These results ... may reassure many urban clinicians that high-quality cancer care can be provided at rural centres by teleoncology models.
"To ensure a high level of safety and quality, centres embarking on providing chemotherapy and complex medical therapies in rural areas using telehealth models need to ensure that rural resources are adequate and that governance arrangements are strict.
"By expanding the scope of practice and capabilities of rural health care systems through the use of telehealth models, rural patients may gain access to chemotherapy and other complex medical therapies similar to that of urban patients."