A new study published in JAMA Oncology suggests that for patients with late-stage cancer, telerehabilitation at home—telemedicine with physical therapy-directed pain management—can make a bigger difference than pain medications when it comes to function, pain, and inpatient care. Patients with advanced-stage cancer often experience decreased function, increased pain, and a higher length of hospital stay and use of post-acute care facilities, which altogether can lead to loss of independence. The Collaborative Care to Preserve Performance in Cancer (COPE) study explored whether collaborative telerehabilitation with or without pharmacological pain management could improve these quality-of-life indicators for such patients.
The COPE study, designed as a 3-arm randomized clinical trial with 516 participants over a period of three years, divided patients into a (1) control arm, (2) telerehabilitation arm, or (3) telerehabilitation with pharmacological pain management arm. Analysis of the results revealed that patients in arm 2 experienced improved function, better quality of life, shorter inpatient stays, and reduced pain interference compared to the control arm. However, there was no significant difference between arms 2 and 3, indicating that the addition of pain medicines to telerehabilitation did not improve the patient outcome.
As thorough as the study appears to be, it did not objectively measure the time, cost, and convenience savings to the patient and his/her family in eliminating the need to travel—often long distances—to inpatient medical centers for treatment. For chronically ill patients, spending hours in a car can be very stressful, not to mention the logistics and cost of arranging the trip and managing any tolls or fees. One can imagine the relief afforded by the option of telerehabilitation, which brings therapy into the comfort of the patient’s own home.
The study also did not address the fact that telerehabilitation would enable the ability to monitor patients’ health status at home and the ramifications of such a feature.
Using telemedicine for physical therapy is not a new concept, although this discipline has not gained the flashy attention of specialties such as telestroke. Yet, studies have shown that telehealth physical therapy can be just as effective as in-clinic therapy for some diagnoses. For rural regions that lack a physical therapist, telerehabilitation would bring access to care where previously there was none, and that’s something that nobody can argue against.
To read more about the study, visit the Washington Examiner here.
To read the study itself, visit JAMA Oncology here.