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Increasing access to care for young adults with cancer: Results of a quality-improvement project using a novel telemedicine approach to supportive group psychotherapy*

Published online by Cambridge University Press:  26 July 2016

Laura Melton ,
Benjamin Brewer ,
Elissa Kolva ,
Tanisha Joshi  and
Michelle Bunch
Laura Melton*
Affiliation:
Department of Medicine, Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Benjamin Brewer
Affiliation:
Department of Medicine, Division of Hematology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Elissa Kolva
Affiliation:
Department of Medicine, Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Tanisha Joshi
Affiliation:
Department of Medicine, Division of Hematology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
Michelle Bunch
Affiliation:
University of Colorado Hospital, Aurora, Colorado
*
Address correspondence and reprint requests to: Laura Melton, Department of Medicine, Division of Medical Oncology, University of Colorado Anschutz Medical Campus, MS 8117, 12801 East 17th Avenue, Aurora, Colorado 80045. E-mail: [email protected].
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Abstract

Objective:

Young adults with cancer experience high levels of psychological distress. Group interventions for cancer patients have been effective in reducing levels of psychological distress but suffer from high levels of attrition and serve a limited geographic area. In a quality-improvement project, we converted an existing in-person support group to a telemedicine format in the hopes of improving attendance and reducing geographic disparities in access to care.

Method:

Eight young adults (18–40 years) with cancer were recruited from across Colorado. Participants received a tablet equipped with Wi-Fi and downloaded an HIPAA-compliant video-conferencing application. Participants attended six weekly supportive psychotherapy sessions.

Results:

Participants found the group to be beneficial: the technology worked, they enjoyed the group format, and they would recommend it to others. The novel treatment interface allowed for low attrition rates due to the flexibility of a patient's location during the intervention. It allowed for provision of services to a geographically diverse population of medically ill young adults, as participants lived an average of 148 miles from the cancer center (range = 25–406 miles).

Significance of results:

Internet-based mental health care is an area of growing interest for providers, but few studies have evaluated its efficacy in patients with cancer, and even fewer in young adults with cancer. Incorporating technological advances into clinical practice will increase access to care, reduce geographic health disparities, and provide more consistent services.

Keywords

Young adultsCancerTelemedicineInternet-based interventionsSupport group
Type
Original Articles
Information
Palliative & Supportive Care , Volume 15 , Issue 2 , April 2017 , pp. 176 - 180
Copyright
Copyright © Cambridge University Press 2016 

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Footnotes

*

This is a report on an innovative quality-improvement effort to utilize telemedicine technology to increase access to support groups for young adults with cancer.

References

REFERENCES

Anderson, M. (2015). Technology device ownership: 2015. Pew Research Center. Available from http://www.pewinternet.org/2015/10/29/technology-device-ownership-2015.Google Scholar
Applebaum, A.J., Lichtenthal, W.G., Pessin, H.A., et al. (2012). Factors associated with attrition from a randomized controlled trial of meaning-centered group psychotherapy for patients with advanced cancer. Psycho-Oncology, 21(11), 1195–1204. Epub ahead of print Jul 12, 2011.CrossRefGoogle ScholarPubMed
Bouma, G., Admiraal, J.M., de Vries, E.G., et al. (2015). Internet-based support programs to alleviate psychosocial and physical symptoms in cancer patients: A literature analysis. Critical Reviews in Oncology/Hematology, 95(1), 26–37. Epub ahead of print Jan 31.Google Scholar
Breen, S., Ritchie, D., Schofield, P., et al. (2015). The Patient Remote Intervention and Symptom Management System (PRISMS): A telehealth-mediated intervention enabling real-time monitoring of chemotherapy side-effects in patients with haematological malignancies. Study protocol for a randomised controlled trial. Trials, 16(1), 472.CrossRefGoogle ScholarPubMed
Breitbart, W., Rosenfeld, B., Pessin, H., et al. (2015). Meaning-centered group psychotherapy: An effective intervention for improving psychological well-being in patients with advanced cancer. Journal of Clinical Oncology, 33(7), 749–754. Epub ahead of print Feb 2.CrossRefGoogle ScholarPubMed
Carlson, L.E., Lounsberry, J.J., Maciejewski, O., et al. (2012). Telehealth-delivered group smoking cessation for rural and urban participants: Feasibility and cessation rates. Addictive Behaviors, 37(1), 108–114. Epub ahead of print Sep 16, 2011.Google Scholar
Fernandez, C.V. & Barr, R.D. (2006). Adolescents and young adults with cancer: An orphaned population. Paediatrics & Child Health, 11, 103–106.Google Scholar
Haozous, E., Doorenbos, A.Z., Demiris, G., et al. (2012). Role of telehealth/videoconferencing in managing cancer pain in rural American Indian communities. Psycho-Oncology, 21(2), 219–223. Epub ahead of print Dec 22, 2010.Google Scholar
Hilty, D.M., Ferrer, D.C., Parish, M.B., et al. (2013). The effectiveness of telemental health: A 2013 review. Telemedicine Journal and E-Health, 19(6), 444–454.Google Scholar
Kim, B. & Gillham, D.M. (2013). The experience of young adult cancer patients described through online narratives. Cancer Nursing, 36(5), 377–384.CrossRefGoogle ScholarPubMed
Lebel, S., Beattie, S., Ares, I., et al. (2013). Young and worried: Age and fear of recurrence in breast cancer survivors. Health Psychology, 32(6), 695–705. Epub ahead of print Oct 22, 2012.Google Scholar
Mayer, C. & Damore-Petingola, S. (2015). Using telehealth to respond to distress in rural and remote chemotherapy clinics. In Handbook of oncology social work: Psychosocial care for people with cancer. Christ, C.E. et al. (eds.), pp. 155–162. Oxford: Oxford University Press.Google Scholar
Sabesan, S., Kelly, J., Budden, L., et al. (2015). Telehealth: A new opportunity to discuss smoking cessation with indigenous cancer patients and their families. Psycho-Oncology, 24(10), 1324–1326. Epub ahead of print.Google Scholar
Sansom-Daly, U.M. & Wakefield, C.E. (2013). Distress and adjustment among adolescents and young adults with cancer: An empirical and conceptual review. Translational Pediatrics, 2(4), 167–197.Google Scholar
Shaw, J., Young, J., Butow, P., et al. (2013). Delivery of telephone-based supportive care to people with cancer: An analysis of cancer helpline operator and cancer nurse communication. Patient Education and Counseling, 93(3), 444–450. Epub ahead of print Aug 1.Google Scholar
Spiegel, D. & Classen, C. (2000). Group therapy for cancer patients: A research-based handbook of psychosocial care. New York: Basic Books.Google Scholar
Stephen, J., Rojubally, A., MacGregor, K., et al. (2013). Evaluation of CancerChatCanada: A program of online support for Canadians affected by cancer. Current Oncology, 20(1), 39–47.CrossRefGoogle ScholarPubMed
Universal Service Administrative Company (2013). Network plan: Colorado Telehealth Network (CTN) as per para. 241 of the HCF order. Available from http://usac.org/_res/documents/.Google Scholar
U.S. Census Bureau (2010). Guide to 2010 Census State and Local Geography–Colorado. Available from http://www.census.gov/geo/reference/guidestloc/st08_co.html.Google Scholar
Wu, X.C., Groves, F.D., McLaughlin, C.C., et al. (2005). Cancer incidence patterns among adolescents and young adults in the United States. Cancer Causes & Control, 16(3), 309–320.Google Scholar
Zebrack, B., Bleyer, A., Albritton, K., et al. (2006). Assessing the health care needs of adolescent and young adult cancer patients and survivors. Cancer, 107(12), 2915–2923.Google Scholar
Zeltzer, L.K. (1993). Cancer in adolescents and young adults: Psychosocial aspects. Long-term survivors. Cancer, 71(Suppl. 10), 3463–3468.Google Scholar