e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Evaluation of initial virtual telephone clinics for new patient referrals at a large United Kingdom Phase 1 Cancer Clinical Trials Unit – A necessary innovation in the era of COVID-19 and social distancing (#344)

Abhijit Pal 1 , Mary V Zyl 1 , Bridget Cooley 1 , Janet Hanwell 1 , Andrea Biondo 1 , Rajiv Shinde 1 , Sachin Khurana 1 , Thubeena Manickavasagar 1 , Julia Lai-Kwon 1 , Crescens Tiu 1 , Anna Minchom 1 , Udai Banerji 1 , Johann De Bono 1 , Deme Karikios 2 , Frances Boyle 3 , Juanita Lopez 1
  1. Drug Development Unit, Royal Marsden Hospital, Sutton, London, United Kingdom
  2. Medical Oncology, Nepean Hospital, Kingswood, New South Wales, Australia
  3. Medical Oncology, Mater Hospital, North Sydney, New South Wales, Australia

Aims The COVID-19 pandemic has demanded that healthcare providers reduce footfall in hospitals as far as possible to improve safety for patients and staff. After the United Kingdom was released from lockdown in May, we instituted virtual telephone clinics prior to an in-person visit for the assessment of new referrals – we aimed to evaluate this process prospectively.

Methods We prospectively collected data from 18th May when clinical trial recruitment resumed at our unit.  Virtual clinics were conducted by a clinical trials fellow alone or in conjunction with a clinical nurse specialist.  Phone conversations took 30 – 60 minutes and consisted of a medical history, assessment of performance status and initial discussion about Phase 1 clinical trials. This “virtual clinic patient” was discussed in a departmental trial allocation MDT and the patient was called back with the outcome.

Results In the 2 month period from 18th May – 18th July,  virtual clinics were conducted with 118 patients.  64 patients (55%) did not proceed to an in person clinic review – 25 were unsuitable trial patients due to an acute medical issue or poor performance status, 16 were suitable trial patients but were on treatment and awaiting their next scan, 17 required further investigation or management prior to assessment and 5 were suitable patients but we had no clinical trial for them due to their tumour type.  As part of a parallel quality improvement project, 14 patients completed a user feedback survey with 93% (11 patients) reporting the telephone clinic experience as satisfactory or highly satisfactory.  

Conclusions Cancer patients referred to clinical trial units are often unsuitable to be seen immediately for a range of reasons, and we showed that a structured virtual telephone clinic can be used to reduce unnecessary visits, especially important during COVID-19, without compromising the patient experience.