OS05.6.A TELEMEDICINE IN NEURO-ONCOLOGY - AN EVALUATION OF REMOTE CONSULTATIONS DURING THE COVID-19 PANDEMIC

Abstract

Abstract BACKGROUND To minimize the risk of infections during the Covid-19 pandemic, remote video consultations (VC) experienced an upswing in most medical fields. However, despite its multiple benefits, telemedicine in neuro-oncology comprises unique challenges and opportunities: Comprehensive neurological examinations that might not translate sufficiently to VC are very relevant for neuro-oncological patients. Also, communication in neuro-oncology can be highly emotional and challenging on a personal level, and VC have been accused of creating emotional distance between the patients and doctors. So far, evidence-based insights to evaluate and potentially customize current concepts of VC in neuro-oncology are scarce. MATERIAL AND METHODS We analyzed >3.700 neuro-oncological consultations conducted at our institution between the 1st of April 2020 and the 30th of June 2021, of which >300 were conducted as VC by patients' preference. Then we collected patients' basic demographic and clinical data and compared how the collective of patients that chose to participate in VC distinguished from those who did not. Also, we examined the reasons, suitable/less suitable encounters, VC's benefits and disadvantages and future opportunities by conducting an anonymized survey in the VC collective. RESULTS The ratio of VC participation correlated with the incidence of SARS-CoV-2 infections (r=0.5, p=0.03). Patients that participated in VC had worse clinical conditions and higher grades of malignancy, were more often diagnosed with glioblastoma, and had a longer travel distance (all p<0.01). VC were considered a fully adequate alternative to face-to-face consultations for almost all encounters that patients chose to participate in (>70%), except initial consultations. Most participants preferred to alternate between both modalities rather than participate in one alone but preferred VC over telephone consultation. Patients stated that VC made them feel safer. Participants also expressed interest in implementing other telemedicine modalities (e.g. apps) into neuro-oncology. CONCLUSION VC are a promising addition to patient care in neuro-oncology. However, patients and encounters should be selected individually. Patient subgroups that might be especially suitable for VC are patients with long travel distances seeking an expert opinion, patients in poor clinical condition, glioblastoma patients and patients requiring frequent consultations in person. A strength of face-to-face consultations is the more intense personal contact, whereas VC convince with a lower expense. VC made patients feel safer, and participants expressed their interest in expanding the offer of telemedicine in neuro-oncology further.