Exploring patient experiences with a telehealth approach for the PRO-ACTIVE trial intervention in head and neck cancer patients.

INTRODUCTION: Following the COVID-19 directive to cease non-essential services, a rapid shift was made in the delivery of Speech Language Pathology (SLP) dysphagia management in the 3-arm, randomized PRO-ACTIVE trial. To inform future programs, this study explored patients' experiences with telehealth when the planned in-person SLP intervention was moved to a telehealth modality. METHODS: A theory-guided qualitative descriptive approach was used. Willing participants who had received at least one telehealth swallowing therapy session participated in a one-time semi-structured interview. Interview transcripts were subjected to a standard qualitative content/theme analysis. Researchers reviewed all transcripts and used a multi-step analysis process to build a coding framework through consensus discussion. Summaries and key messages were generated for each code. RESULTS: Eleven participants recounted their telehealth experiences and reported feeling satisfied, comfortable and confident with the session(s). They identified that previous experience with teleconferencing, access to optimal technical equipment, clinician skill, and caregiver assistance facilitated their telehealth participation. Participants highlighted that telehealth was beneficial as it reduced commuting time, COVID-19 exposure and fatigue from travel; and also allowed caregiver participation particularly during COVID. In comparing their in-person SLP sessions to telehealth sessions, limitations were also identified, including: lack of previous experience with and/or poor access to technology, and less opportunity for personalization. Participants indicated that use of phone alone was less preferred than an audio/video platform. DISCUSSION: Patients reported that overall, telehealth sessions did not compromise their learning experience when compared to in-person sessions. Patients benefited from use of telehealth in several ways despite some limitations of the use of technology. Patient feedback about telehealth provides an important perspective that may be critical to inform best practices for care delivery.

EXPLORING PATIENT EXPERIENCES WITH A TELEHEALTH BEHAVIOURAL SWALLOWING INTERVENTION FOR THE PRO-ACTIVE TRIAL IN PATIENTS WITH HEAD AND NECK CANCER

Introduction In response to COVID-19, a rapid shift was made to deliver behavioural swallowing therapy in the PRO-ACTIVE trial via a TeleHealth (TH) approach. Patient experiences with TH were explored. Methods A theory-guided qualitative approach explored the perspective of consenting participants who received at least one TH swallowing therapy session. Patients participated in a one-time semi-structured interview. Interview transcripts were analyzed for content and theme using a multi-step consensus process to build a coding framework and key messages. Results Eleven participants recounted their TH experiences and reported feeling satisfied, comfortable and confident with the session(s). Facilitating factors included: previous experience with teleconferencing, access to optimal equipment, clinician skill, and caregiver assistance. TH was considered beneficial to reduce commuting time, potential exposure to COVID19, energy expenditure and also allow caregiver participation. Limitations were also identified, including lack or poor previous experience with technology, and less opportunity for personalization. Participants indicated that use of audio alone was less preferred than an audio/video platform. Conclusions Patients reported overall that TH sessions did not compromise their clinical learning experience when compared to in-person sessions. Patient feedback about TH provides an important perspective to inform best practices for care delivery.