CN17 - Use of the ONCO'nect telemonitoring tool by socially deprived outpatients actively treated for a solid cancer: A retrospective quantitative and qualitative analysis of the Re'connect program

Background

Telehealth improves the quality of life and overall survival of cancer patients. Social deprivation might lead to unequal access to telehealth. The aim of this study was to evaluate how socially deprived outpatients treated for a solid cancer get a grip on a dedicated telemonitoring program.

Methods

Between February 2021 and June 2022, eligible outpatients with a solid cancer undergoing chemotherapy at the Mondor Teaching Hospital, France, were provided with the ONCO'NECT® telemonitoring tool. It includes a chat system and standardized 24 items questionnaires before/after each treatment administration based on the NCCI Patient-Reported Outcomes of the Common Terminology Criteria for Adverse Events (PRO-CTCAE®), triggering alerts when the threshold of clinical significance was reached. Patients with social deprivation were identified based on the EPICES (evaluation of precariousness and health inequalities in health examination centres) score and were enrolled in the Re’Connect program (lending of a tablet, caregivers, technical and peer-to-peer support). We collected the data on patients’ healthcare pathways retrospectively, and we performed semi-structured interviews to assess patients’ challenges related to ONCO'NECT®.

Results

We enrolled 22 patients: 15 females, 50% were aged > 70 years (interquartile range (IQR), 64-74), 14 had digestive cancer, 15 patients had metastases, 14 lived alone. Five and three patients completed > 75% and < 25% of questionnaires respectively, during a median treatment duration of 7,5 months (IQR, 4-14). The median number of triggered alerts was 5 per patient (IQR, 1-9,25). The underuse of ONCO'NECT® went beyond patients’ understanding of its interest and their technical competence and was related to borderline health literacy. The related patients’ emotional negative experience might explain such an underuse.

Conclusions

Socially deprived cancer outpatients perceived the relevance of a telehealth tool. Beyond technical issues, patients’ borderline health literacy and their negative emotional experience should be addressed to ensure equal access to telehealth.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

French Cancer National Institute: Grant number PRECA20-009.

Disclosure

All authors have declared no conflicts of interest. Cancer nursing: Health promotion, prevention and screening