Completion rate and impact on physician-patient relationship of video consultations in medical oncology: A randomised controlled open-label trial

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Thomas Walle - , German Cancer Research Center (DKFZ) (Author)
  • Erkin Erdal - , German Cancer Research Center (DKFZ), University of Hamburg (Author)
  • Leon Mühlsteffen - , German Cancer Research Center (DKFZ), Minxli AG (Author)
  • Hans Martin Singh - , German Cancer Research Center (DKFZ) (Author)
  • Editha Gnutzmann - , German Cancer Research Center (DKFZ) (Author)
  • Barbara Grün - , German Cancer Research Center (DKFZ) (Author)
  • Helene Hofmann - , German Cancer Research Center (DKFZ) (Author)
  • Alexandra Ivanova - , German Cancer Research Center (DKFZ) (Author)
  • Bruno Christian Köhler - , German Cancer Research Center (DKFZ) (Author)
  • Felix Korell - , Heidelberg University  (Author)
  • Athanasios Mavratzas - , German Cancer Research Center (DKFZ) (Author)
  • Andreas Mock - , German Cancer Research Center (DKFZ) (Author)
  • Constantin Pixberg - , German Cancer Research Center (DKFZ) (Author)
  • David Schult - , Heidelberg University  (Author)
  • Helen Starke - , German Cancer Research Center (DKFZ) (Author)
  • Niels Steinebrunner - , German Cancer Research Center (DKFZ) (Author)
  • Lena Woydack - , German Cancer Research Center (DKFZ) (Author)
  • Andreas Schneeweiss - , German Cancer Research Center (DKFZ) (Author)
  • Mareike DIetrich - , German Cancer Research Center (DKFZ) (Author)
  • DIrk Jäger - , German Cancer Research Center (DKFZ) (Author)
  • Johannes Krisam - , Heidelberg University  (Author)
  • Jakob N. Kather - , National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Consortium (DKTK) Core Center Heidelberg (Author)
  • Eva C. Winkler - , German Cancer Research Center (DKFZ) (Author)

Abstract

Background Mobile phone video call applications generally did not undergo testing in randomised controlled clinical trials prior to their implementation in patient care regarding the rate of successful patient visits and impact on the physician-patient relationship. Methods The National Center for Tumour Diseases (NCT) MOBILE trial was a monocentric open-label randomised controlled clinical trial of patients with solid tumours undergoing systemic cancer therapy with need of a follow-up visit with their consulting physician at outpatient clinics. 66 patients were 1:1 randomised to receive either a standard in-person follow-up visit at outpatient clinics or a video call via a mobile phone application. The primary outcome was feasibility defined as the proportion of patients successfully completing the first follow-up visit. Secondary outcomes included success rate of further video calls, time spent by patient and physician, patient satisfaction and quality of physician-patient relationship. Findings Success rate of the first follow-up visit in the intention-to-treat cohort was 87.9% (29 of 33) for in-person visits and 78.8% (26 of 33) for video calls (relative risk: RR 0.90, 95% CI 0.70 to 1.13, p=0.51). The most common reasons for failure were software incompatibility in the video call and no-show in the in-person visit arm. The success rate for further video visits was 91.7% (11 of 12). Standardised patient questionnaires showed significantly decreased total time spent and less direct costs for patients ("mean -170.8 min, 95% CI -246 min to -95.5 min), p<0.0001; "mean -€14.37, 95% CI -€23.9 to -€4.8, p<0.005) and comparable time spent for physicians in the video call arm ("mean 0.5 min, 95% CI -5.4 min to 6.4 min, p=0.86). Physician-patient relationship quality mean scores assessed by a validated standardised questionnaire were higher in the video call arm (1.13-fold, p=0.02). Interpretation Follow-up visits with the tested mobile phone video call application were feasible but software compatibility should be critically evaluated. Trial registration number DRKS00015788.

Details

Original languageEnglish
Article numbere000912
JournalESMO open
Volume5
Issue number6
Publication statusPublished - 17 Nov 2020
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 33203685

Keywords

Sustainable Development Goals

ASJC Scopus subject areas

Keywords

  • digital health, physician-patient relationship, shared decision-making, smartphone, telemedicine