Telemedicine adoption, pandemic-related fear, and treatment adherence in cancer care during COVID-19: a prospective cohort study

Clinical Snapshot

Key Findings

• P Value: Hospital visits p = 0.004, emergency utilization p < 0.001, mortality p = 0.032

• Effect Size: Telemedicine reduced hospital visits (7.3 vs 9.4 visits) and emergency utilization (16.2% vs 46.4%)

• Primary Outcome: Treatment adherence and healthcare utilization patterns

• Nnt Or Sensitivity: High fear associated with increased mortality (8.1% vs 2.7%) and disease progression (37.8% vs 21.4%)

• Confidence Interval: OR for treatment modifications: COVID-19 infection (OR = 2.8, 95% CI:1.7-4.6), neutropenia (OR = 2.1, 95% CI:1.3-3.4)

Clinical Application

Telemedicine adoption was modest (24.8%) suggesting implementation barriers that need addressing Relevant to Australian oncology practice given Medicare telehealth items introduced during COVID-19. Findings support continued PBS-funded remote monitoring and psychological support services Cancer patients receiving active treatment during health system disruptions

Abstract

PURPOSE: To evaluate the impact of telemedicine adoption and pandemic-related fear on treatment adherence, healthcare utilization, and supportive care processes among patients undergoing cancer therapy during the COVID-19 pandemic. METHODS: In this prospective cohort study, we followed 149 cancer patients over two years to evaluate telemedicine utilization, treatment modifications, and COVID-19-related fear. We employed validated psychometric tools, including the COVID-19 Fear Scale. RESULTS: Telemedicine adoption (24.8% of patients) was associated with fewer hospital visits (7.3 ± 3.2 vs 9.4 ± 4.1, p = 0.004) and reduced emergency room utilization (16.2% vs 46.4%, p < 0.001). Treatment modifications occurred in 55.9% of patients, predicted by COVID-19 infection (OR = 2.8, 95% CI:1.7-4.6) and neutropenia (OR = 2.1, 95% CI:1.3-3.4). High fear scores were linked to increased mortality (8.1% vs 2.7%, p = 0.032), disease progression (37.8% vs 21.4%, p = 0.018), lower treatment adherence (75.7% vs 87.5%, p = 0.041), and higher hospitalization rates (51.3% vs 24.1%, p < 0.001). CONCLUSION: This study demonstrates that telemedicine can reduce acute care utilization while treatment modifications and high pandemic-related fear significantly worsen cancer outcomes. These findings highlight the need for oncology teams to proactively integrate remote care strategies and targeted psychological support to maintain treatment adherence and mitigate adverse outcomes during health crises.

References

1. 1.Ulkucu, A., Uzunoglu, S., Cicin, I., & Hacioglu, M. B. (2026). Telemedicine adoption, pandemic-related fear, and treatment adherence in cancer care during COVID-19: a prospective cohort study. Supportive Care in Cancer. https://doi.org/10.1016/j.ajog.2020.06.049