Telehealth vs face-to-face consultations in a urological oncology clinic: a randomised controlled trial

To determine the effectiveness of telehealth, among patients reviewed for urological oncological diseases, compared with standard face-to-face (F2F) consultations with regard to patient-reported satisfaction through use of a validated questionnaire.

We conducted a single-centre randomised controlled trial in 126 patients recruited from the Crown Princess Mary Cancer Centres urological oncology clinics. Patients were randomised to either a telehealth audio-only (telephone) consultation group or a standard F2F consultation group for their next routine appointment. Validated questionnaires, using a 4-point Likert index scale, were completed at the end of the appointments. Questionnaire scores were analysed using the Mann-Whitney U-test. The primary outcome measured was patients' preference for type of consultation on subsequent follow-up. Secondary outcomes involved evaluation of efficiency, quality of care, ease of understanding, overall satisfaction, professionalism, limitations, and convenience.

A total of 63 patients in the F2F group and 53 patients in the telephone group completed and returned the validated questionnaires. Patients' preference for next follow-up was statistically significant, favouring the telephone group (P = 0.012). For the secondary outcomes, patients in the telephone group also reported greater satisfaction with regard to the efficiency and timing of the consultation (P = 0.005). Conversely, patients in the F2F group reported higher rates of satisfaction with regard to 'tests and follow-up' and the clinician's ability to deal with their issues, as compared to the telephone group (P = 0.002). Also, patients in the F2F group reported higher rates of perceived quality of consultation (P = 0.027).

Our study demonstrates that patients with urological oncological diseases attending routine follow-up generally prefer telehealth over F2F appointments. However, patients in the F2F group perceived that there was a higher quality of care in their consultation, and that the services provided were superior, in comparison to patients in the telehealth group. These are barriers to the widespread adoption of telehealth in urological oncology follow-up care and are rarely reported in the current literature.