Madam — The COVID-19 pandemic has challenged the delivery of care worldwide, with many outpatient clinics changing from face-to-face to telephone consultations [1]. This is particularly challenging in neuro-oncology, where often complex interventions need to be discussed and where communication can be compromised due to tumour-related language/cognitive deficits. We therefore sought to evaluate the patient-reported experience on telephone clinics that were conducted and formulated a voluntary, confidential nine-question patient-reported experience measure – King's Patient Experience Measure in Neuro-oncology Questionnaire (K-PEN Q; see Supplementary Material) – to prospectively evaluate the experience of 50 consecutive neuro-oncology patients at our quaternary neurosurgical centre with four domains: clinic environment/time (three questions), patients' questions/queries (three questions), follow-up (two questions) and feedback (one question); the answers were divided into a Likert scale of strongly agree, agree, neutral, disagree and strongly disagree. Although more than 90% of patients had had previous face-to-face clinic consultations in the pre-COVID era; more than a third agreed on preferring telephone over the face-to-face clinic and almost half still preferred the face-to-face consultations.Our data showed that although a neuro-oncology telephone clinic can replace face-to-face ones with efficiency and a high degree of satisfaction in certain settings, they are not a substitution. Over 50% of our patients preferred an in-person clinic and although telemedicine [1] might address some of the concerns, such as enabling viewing of the imaging or the face of the health care professional, others, such as the possibility of a physical examination or quest for ‘real personal care’, will not be readily addressed. Thus, although in a patient with stable imaging a telephone consultation can be the optimal option, for new patients or those requiring interventions, an in-person clinic is much more likely to provide the best experience. Moving forward, we suggest a hybrid model, incorporating the new technology where indicated but also maintaining what makes medicine clinical, namely its human touch at the ‘bedside’.
Authors: Lekhaj C Daggubati; Daniel G Eichberg; Michael E Ivan; Simon Hanft; Alireza Mansouri; Ricardo J Komotar; Randy S D'Amico; Brad E Zacharia Journal: World Neurosurg Date: 2020-05-22 Impact factor: 2.104