Using Hybrid Telemedicine Model to Care for Patients with Breast Cancer: a Natural Quasi-Experimental Study

Abstract

Introduction: This investigation assessed the clinical characteristics of patients who received care through telemedicine and the clinical impact telemedicine service had on breast cancer patients in a low-income country. Materials and Methods: This natural experimental study assessed the impact of telemedicine service on cancer outcomes among breast cancer patients at Shaukat Khanum Memorial Trust (SKMT), Pakistan, between January 1st, 2018, to December 31st, 2022. The study group (hybrid group) consisted of patients that had both face-to-face and telemedicine appointments, and the control group (physical group) included patients with only face-to-face encounters. Results: A total of 3,205 patients were included in the analysis. Among those included in the analysis, 3,188 (99.5 %) were females, and the mean age of the cohort was 48.10 ± 11.94 years. Statistically significant differences were observed between the two groups in age, demographic distribution, disease stage, average number of emergency room visits, mean length of stay in the Intensive care unit, and the final patient status (alive at the end of observation period). However, the binary logistic regression model (forward-LR) suggested that the final patient outcome was related to disease relapse, COVID-19 infection, and age. Conclusion: Telemedicine clinics, when conducted in parallel with physical clinics (hybrid setup), are safe and have a clinical impact similar to having just physical encounters among breast cancer patients in a low-income country.