Work

Users’ perspective and economic analysis of eCAN multi-national telemedicine cancer intervention

Year: 2026

Type: article

Abstract: eCAN randomized trial piloted tele-rehabilitation in postoperative breast (P1a) and head-and-neck cancer patients (P1b) and tele-psychological consultations in advanced cancer patients (P2) against standard of care in 18 cancer centers, 10 countries, 2023-4. The intervention groups received weekly tele-rehabilitation (P1a,P1b) or weekly psycho-oncological teleconsultations (P2) over 8 weeks. Primary endpoint was quality of life at week 8 (EORT QLQ-C30). We report patients’, organizational and economic perspective of mixed-methods evaluation study. Cost-consequence and cost-utility analyses based on implementation, operational costs (hospital perspective: focus groups, interviews, pilot site questionnaire), and costs/time spent (patient perspective: questionnaire at week 9-12) assuming 8 wks time horizon and 50/100/200 patients. Intervention group filled telehealth and mobile app usability questionnaires (TUQ, MAUQ) at week 9-12, each site performed a SWOT focus group. 251 patients took part in the pilots, 123 in intervention group (71% without prior experience with teleconsultations). The tele-rehabilitation was cost-effective in all scenarios (ICER/QALY 14.9 – 36.6 thousands EUR), driven by low operational costs and reduced patient time and travel burden. The tele-psychological support was not cost-effective possibly due to short time horizon. TUQ/MAUQ average item scores were 6.3 [IQR 5.2-6.8]/ 5.7 [4.8 – 6.7] (scale 1-7), not differing by prior experience. Centres’ capacity, close collaboration between partners and high patients’ involvement were considered strengths; strict inclusion criteria, technical issues and limited training time – weaknesses; inclusion into routine care, improved cost-effectiveness, involving wider patient groups – opportunities; lack of infrastructure, poor digital literacy, data security issues – threats. Telemedicine in supportive cancer care demonstrates good usability, is feasible, and, in selected applications, cost‑effective. Key messages • Telemedicine in supportive cancer care demonstrates satisfactory usability, is feasible, and, in selected applications, cost effective. • Lack of infrastructure, poor digital literacy, data security issues present threats to successful future implementation.

Source: European Journal of Public Health

DOI: 10.1093/eurpub/ckag169.201