B80-4-35 Consumer Perspectives on a Novel, Virtual, Ambulatory Model of Care for Malignant Pleural Effusion

Abstract Introduction Malignant pleural effusion (MPE) is a complication of advanced cancer and is associated with breathlessness, impaired quality of life and poor survival. MPE is a frequent cause of hospitalisation and management is complex, expensive and variable across health services. Anecdotally, many centres lack the infrastructure and expertise for ambulatory MPE care. A virtual, ambulatory model of care; the Specialist Ambulatory Pleural Service (SAPS), was devised to improve access to available therapies, minimise hospitalisation, standardise decision-making and predict early deterioration. SAPS integrates home nurse visits with physician-led telehealth, teleultrasound and longitudinal symptom monitoring. Post-pleural intervention, follow up occurred at two weeks and then monthly, up to six months (or death). We evaluated the usability and consumer experience of the SAPS model of care. Methods Consecutive people with MPE who were enrolled in SAPS were invited to answer a modified 13-item questionnaire to assess the usability experience of the SAPS model of care, based on the Health Information Technology Usability Evaluation Scale (Health-ITUES). Responses were ordered on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). They were also invited to participate in a semi-structured interview to describe the consumer experience, based on the Health Information Technology Usability Evaluation Model (Health-ITUEM). Surveys were administered by SAPS nurses each home visit. Interviews were conducted by an independent researcher not involved in clinical care and occurred at least four weeks post enrolment. Interviews ceased once thematic saturation was reached. Each interview was recorded, transcribed, anonymised and then analysed using the Framework Method. Results In total, n = 39 people with MPE provided 162 survey responses (mean 4.05 ± 2.01 responses per person) and n = 15 interviews. Mean survey scores per item ranged from 4.5 to 4.8 out of 5.0, indicating a very high degree of usability. Mixed-effects models accounting for within-person clustering showed no significant change in scores over time. Qualitative analysis identified themes of personalised care, convenience and empowerment. Respondents described SAPS as accessible, reassuring and efficient, enabling early symptom recognition and timely clinical contact. Technical issues were infrequent and readily resolved. Conclusion People with MPE consistently agreed that the SAPS model of care was highly usable. Interview responses were supportive of the benefits of an ambulatory management approach for MPE that was supported by technology. These responses support the continued evaluation of the SAPS model of care and consideration of its potential for broader implementation to improve MPE care. This abstract is funded by: HCF Research Foundation, Victorian Nurses and Midwives Trust, Medibank Foundation