Telehealth Preferences among Patients with Advanced Cancer in the Post COVID-19 Vaccine Era

Background Few studies have examined patient preferences for telehealth in palliative care after the availability of COVID-19 vaccines. We examined patient preferences for video versus in-person visits and factors contributing to preferences in the post-vaccine era. Methods This is a cross-sectional survey of patients who were seen at our palliative care clinic between April 2021 and March 2022. Patients were surveyed directly their preference for either video or in-person visits for outpatient palliative care (primary outcome). We also surveyed preferences including convenience, cost, wait time, and perceptions of COVID-19 safety regarding their palliative virtual-video visit. We examined clinical factors associated with preferences with multivariate logistic regression. Results 200 patients completed the survey. 132 (67%, 95% confidence interval [CI]: 60%, 74%) preferred virtual-video, while 16 (8%) preferred in-person visits during the COVID-19 pandemic. 120 (61%, 95% CI: 54%, 68%) preferred virtual-video after the pandemic. Patients perceived virtual-video favorably regarding travel and related costs (179 [91%]), convenience (175 [88%]), and wait time (136 [69%]). Multivariable analysis showed concerns for catching COVID-19 from healthcare providers (odds ratio [OR]: 4.20; 95% CI: 1.24–14.25; P=0.02) and feeling comfortable with computers or mobile devices (OR: 4.59; 95% CI: 1.02, 20.60; P=0.047) were significantly associated with preferring virtual-video. Patients who were of Hispanic or Latino ethnicity (OR: 0.25; 95% CI: 0.09, 0.71) and had increased dypsnea (OR: 0.74; 95% CI: 0.59, 0.93) were less likely to prefer video over in-person. Conclusion Patients expressed strong preference for video over in-person visits in the outpatient palliative care setting.