Aims: Although comprehensive survivorship care is recommended, many survivors face barriers which can lead to healthcare disengagement. Australia's survivorship services are reaching capacity, and the traditional clinical-care model is struggling to meet the growing survivor populations needs. This study evaluated the effectiveness of a novel telehealth intervention called 'Engage’ on survivors health-efficacy and quality of life. 'Engage' offers multidisciplinary reviews and personalized health-recommendations to survivors, aiming to facilitate transition of low to mid-risk survivors into primary-care.
Methods: 'Engage' is a distance-delivered intervention comprising: i) an online patient-reported health and lifestyle assessment, ii) an online nurse-led consultation, iii) a multidisciplinary case-review, iv) personalized education, recommendations, and a treatment summary for survivors and their Primary Care Physician, and v) a follow-up online nurse-led consultation to ensure understanding. Childhood cancer survivors treated at Sydney Children's Hospital, who had not received cancer-related care in over two-years and were more than five-years post-diagnosis, participated. We assessed survivors’ outcomes prior to the intervention and at 1-, 6-, 12-, and 24-months post-intervention.
Results: Seventy-eight survivors participated (62% male, mean-age=30 years, mean time since diagnosis=23 years, 14% living rurally). Survivors’ health-related self-efficacy significantly increased from pre- to post-intervention (p<0.001) and remained high for 24-months (p<0.001). 88% of survivors reported increased confidence in managing their healthcare. Satisfaction with care improved significantly from 63% pre-intervention to 94% at 24-months post-intervention (p=0.008). Information needs decreased from pre- to post-intervention (p=0.02). Survivors valued telehealth delivery of care, reporting “[Engage was] fast and easy to do, given it could be completed from my own home”.
Conclusions: The 'Engage' program is an innovative, distance-delivered intervention that is feasible and highly acceptable, promoting health-related self-efficacy and empowering survivors to advocate for their own health. Findings emphasize the importance of targeted interventions to reduce treatment-related health problems and improve adherence to survivorship care recommendations among survivors.