Dr Louise Brennan, a Research Fellow and Chartered Physiotherapist based in the School of Medicine, spoke at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago last week. The ASCO Voices session, themed ‘Advancing Equitable Cancer Care Through Innovation’, saw five speakers give a 7 minute presentation, and Dr Brennan’s presentation was entitled ‘Moving Online, Together!’ The session was streamed online to delegates attending remotely globally, and will be made publicly available online. Dr Brennan spoke about a telehealth cancer rehabilitation research programme which was run last year. The ReStOre II cancer rehabilitation randomised controlled trial (RCT) could not proceed at the time due to COVID restrictions, so the research group converted the programme to an online model of delivery. By using telehealth and remote monitoring technologies, they ran the rehabilitation programme fully online, enabling people to access cancer rehab and participate in research in a whole new way. Through embracing a crisis and finding new, innovative, ways of working, the team found that they could improve the reach and the equality of their research. Dr Brennan spoke about the impact of this prestigious presentation:
“This was a unique and valuable opportunity to speak to such a large, diverse and influential group of global oncology professionals about equality and innovation in cancer rehabilitation. It was a privilege to represent Trinity College and Trinity St James Cancer Institute at ASCO 2022”.
The ReStOre RCT sought to investigate the impact of a 12-week multi-disciplinary rehabilitation programme on cardiorespiratory fitness and quality of life in survivors of upper gastrointestinal cancer. The online model of the ReStOre programme, known as ReStOre@Home, ran as a feasibility study between July and October 2021. The ReStOre@Home programme consisted of group exercise, group education and one-to-one dietitian and physiotherapy sessions. Researchers partnered with Salaso Health Solutions Ltd, an Irish technology company based in Tralee, and used their Digital Therapeutics Platform to run all sessions by videocall. Dr Brennan explained that the online format was very well received and allowed them to recruit patients nationwide:
“Participants were overall very satisfied with the programme, and we saw individual meaningful improvements in physical fitness and nutritional status. Participants appreciated the convenience of the online model of delivery, as there was no travel time, we could schedule calls around their work day or other commitments and they could join calls from any location. As there were no geographical constraints to recruitment, we could recruit patients who lived all over Ireland. This represents a huge step forward in increasing equality of access to our trials.”
Participants were supported to take part regardless of their level of skill in using digital technologies. However, the researchers noted that low levels of digital skills and lack of broadband internet meant that some patients were unable to take part. Through this, researchers saw how telehealth can improve access to healthcare for some, but reduce access for other groups. Therefore, the team stressed that it is important that all patients are offered both in-person and online options for cancer rehabilitation services.
Participants also recommended that some elements of in-person content be integrated into the online model, such as occasional in-person education sessions. This will allow the group to better develop connections and will enhance the peer support aspect of the programme. Dr Brennan described the group’s next steps:
“When we were finally able to launch the ReStOre II RCT earlier this year, we changed the protocol to a hybrid model of delivery, so that every participant has the choice to join sessions primarily online or in-person. This study is ongoing and will recruit 120 participants with upper GI cancer over the next two years.”
This study, which was funded by the Health Research Board, demonstrated that multi-disciplinary, multi-component cancer rehabilitation programmes can be run using a telehealth model of delivery. Moreover, it demonstrated that this model of online delivery allowed for the recruitment of participants from all over Ireland, something that has historically been challenging. Importantly, the study showed that in-person sessions will be important for some participants, allowing the group to deliver an optimal programme. The academic lead for this study was Professor Juliette Hussey and Professor John Reynolds was clinical lead.
The team’s most recent paper describing the ReStOre@Home feasibility study, recently published in Cancers, is available here: https://www.mdpi.com/2072-6694/14/11/2707
Read a description of the ASCO Voices session, including an interview with Dr Louise Brennan, here: https://dailynews.ascopubs.org/do/10.1200/ADN.22.200916/full/
