Telephone consultation for cancer survivors with unclarified need for rehabilitation in a primary healthcare setting: a mixed methods process evaluation

Abstract

Purpose

To evaluate the implementation of telephone consultations to assess cancer patients’ needs for rehabilitation, with focus on patients’ acceptance, health professionals’ experience and contextual factors.

Methods

A mixed methods process evaluation was conducted at a primary healthcare rehabilitation clinic. Cancer survivors above 18 years of age with an unclarified rehabilitation need at discharge from hospital, was offered a telephone consultation provided by health professionals. Data on implementation and acceptability were collected using medical records systems, data collection forms and semi-structured interviews with six patients and two health professionals.

Results

Eighty-one cancer survivors were referred to the intervention, and 54% continued to further rehabilitation. The telephone consultations were executed approximately eight days after referral and took on average 44 min to deliver. Overall, the patients found that the telephone consultation addressed what they considered the most important topics, and the health professionals found the intervention to be acceptable. Both patients and health professionals reported challenges regarding the referral process.

Conclusion

Patient acceptance of the intervention was high, and the telephone consultation was implemented to a high degree, resulting in more than half of the patients continuing to further rehabilitation. Patients’ and health professionals’ perspectives provided valuable insights about contextual factors.

Keywords:

• Cancer rehabilitation
• needs assessment
• telemedicine
• referral and consultation
• implementation science

Acknowledgements

The authors would like to thank the patients who participated in this study, the health professionals who were involved, as well as the primary healthcare setting. There was no funding involved, but the project was supported by the Department of Public Health (Folkesundhed Aarhus, Midt), Health and Care at the Municipality of Aarhus.

The study was conducted as part of the first author’s master thesis at the University of Southern Denmark, Faculty of Health, Department of Sports Science and Clinical Biomechanics and in collaboration with Centre for Rehabilitation Research (CePR), Department of Public Health at Aarhus University.

Disclosure statement

The authors report there are no competing interest to declare.

Implications for rehabilitation

• Cancer survivors with unclarified or no need for rehabilitation at discharge from the hospital, had their need for rehabilitation successfully assessed using telephone consultations and more than half continued with further rehabilitation.

• Patients found telephone consultations relevant to assess their need for rehabilitation, and the telephone consultation addressed what patients considered most important.

• Telephone consultations for the assessment of needs for rehabilitation should be initiated within already 5-9 days after discharge.

• Collaboration between healthcare providers should be prioritised to organise the infrastructure around the referral process.

Data availability statement

The data sets are not publicly available due to signed consent agreements around data sharing, but the authors will look into possibilities for data sharing on reasonable requests.

Additional information

Funding

The project was supported by the Department of Public Health, Health and Care at the Municipality of Aarhus.