“The telehealth means I get distance from the hospital so I don’t feel so much like a patient”: A qualitative sub-study examining the acceptability of nurse-led follow-up for ovarian cancer via telehealth using the MOST-S26 to structure consultations.

Abstract

12099 Background: The MOST-S26 is a patient-reported outcome measure that complements follow-up after first-line treatment for ovarian cancer (OC). MOST-S26 enables assessment of physical and psychological symptoms, and well-being. A randomized trial was conducted to evaluate nurse-led follow-up for OC via telehealth using the MOST-S26 to structure consultations vs routine hospital follow-up (ACTRN12620000332921). A qualitative sub-study assessed acceptability of the intervention from patient and nurse perspectives. Methods: Semi-structured interviews via video or telephone explored experiences of receiving or delivering nurse-led follow-up. Patients that participated in at least two nurse-led follow-up appointments were eligible. Study nurses delivering the intervention were interviewed at the end of the trial. Interviews were recorded, transcribed and coded using a Framework Approach following five stages: familiarisation, developing a thematic framework, indexing, charting, mapping and interpretation. Results: From June 2021, 38 patients were enrolled at 6 Australian sites. The trial closed to acrual in April 2024. Twenty-one participants were interviewed (15 women with OC and 6 study nurses). Analysis identified 3 overarching themes: (1) key patient-centred benefits (convenience and flexibility; providing a sense of connection and feeling cared for; enabling personalised, holistic care and prompt management of symptoms; providing dedicated space for patients’ to freely express experiences and emotions); (2) challenges to delivery from nurses’ perspectives (emotional impact of patients' cancers recurring; lack of referral pathways; inability to observe physical cues; difficulties establishing rapport; and, lack of suitability for all patients e.g. non-English speaking or patients with low literacy); and, (3) Nurse views on usefulness of MOST-S26 to support consultations (provides a useful tool to guide consultations/referrals, detect recurrence, track symptoms over time, flag symptoms for discussion, and, helps patients’ reflect on their symptoms). Conclusions: Results confirmed acceptability of this type of follow-up for both OC patients and nurses. Both reported several benefits compared with standard hospital-based follow-up. Challenges that should be considered prior to routine implementation of this follow-up model included: the need to provide support to nurses to cope with the emotional impact of patients’ cancers recurring; developing clear referral pathways for symptom management; and considering the characteristics of patients most and least suitable for this type of follow-up. Clinical trial information: ACTRN12620000332921 .