Associations of comorbidities with telehealth use in cancer survivors amidst the COVID-19 pandemic: Findings from the HINTS 6 (2022).

Abstract

522 Background: Cancer survivors with comorbidities often need specialized care. Telehealth, using remote technologies such as phone calls or video conferences, addresses their specific needs, particularly during the COVID-19 pandemic, offering time and cost savings. However, understanding of telehealth use among cancer survivors with comorbidities is limited. This study examines the associations between comorbidities and telehealth use in cancer survivors during the pandemic. Methods: We analyzed the Health Information National Trends Survey (HINTS) 6, a nationally representative survey conducted in 2022. This study included 4,756 adults aged ≥18 (representing 195 million), including 730 cancer survivors (representing 20 million) in the U.S. The outcome variable was telehealth use in the past 12 months, including video or phone call with healthcare providers. Comorbidities included diabetes, hypertension, heart conditions, lung diseases, and depression. Design-based F-test was used for bivariate analyses. Logistic regression was used to determine associations of comorbidities and telehealth use, controlling for sociodemographic and cancer-related clinical factors. All data analyses accounted for the complex survey design and sample weights using jackknife replication method. Results: Cancer survivors’ telehealth use was slightly higher than adults without cancer (50.37% vs. 43.62%). Among cancer survivors, bivariate analysis revealed associations between telehealth use and younger age and higher number of comorbidities (P<.001). These associations remained significant in the logistic regression model (OR=0.25 and 0.12, 95% CI 0.11-0.57 and 0.05-0.29 for ages 61-75 and >75, respectively; OR=1.65, 95% CI 1.32-2.07 for number of comorbidities; all P<.001). When examining specific comorbidities, the logistic regression model indicated that cancer survivors with heart conditions (OR=6.03, 95% CI 2.34-15.54, P<.001), lung diseases (OR=5.53, 95% CI 1.89-16.17, P=.002), and depression (OR=4.46, 95% CI 2.35-8.46, P<.001) were more likely to utilize telehealth compared to those without comorbidities. Additionally, higher education levels were associated with increased telehealth use, even after adjusting for other factors (OR=2.41, 95% CI 1.04-5.59, P=.04). Conclusions: This national survey analysis detected the higher rate of telehealth use in cancer survivors with comorbidities during the pandemic. Further research is needed to explore the experiences of cancer survivors with heart conditions, lung diseases, and depression regarding telehealth. Additional support is necessary to encourage older individuals and those with lower education levels to embrace telehealth for the delivery of optimal and high-quality care.