Experiences with Telehealth for Outpatient Palliative Care: Findings from a Mixed-Methods Study of Patients and Providers across the United States

Bandini, Julia; Scherling, Adam; Farmer, Carrie M.; Fratkin, Michael D.; Mistler, Brian; Ast, Katherine; Ahluwalia, Sangeeta C.

doi:10.1089/jpm.2021.0545

Cited by 21 publications

(17 citation statements)

References 31 publications

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“…Early concerns about the potential difficulty of establishing trust and rapport with patients using virtual platforms were, in general, not borne out [ 43 ]. Nevertheless, caution and attention needed to be applied to avoid barriers to meaningful communication and successful conversations, particularly around complex topics like mortality and grief.…”

Section: Widespread Adoption Of Telemedicinementioning

confidence: 99%

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

Kazazian

Swallow

2022

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of reviewSupportive and palliative care services have been an important component of the overall COVID-19 pandemic response. However, significant changes in the provision and models of care were needed in order to optimize the care delivered to vulnerable cancer patients. This review discusses the evolution of palliative and supportive care service in response to the pandemic, and highlights remaining challenges. Recent findingsDirect competition for resources, as well as widespread implementation of safety measures resulted in major shifts in the mode of assessment and communication with cancer patients by supportive care teams. Telemedicine/virtual consultation and follow-up visits became an integral strategy, with high uptake and satisfaction amongst patients, families and providers. However, inequities in access to the required technologies were sometimes exposed. Hospice/palliative care unit (PCU) bed occupancy declined markedly because of restrictive visitation policies. Collection of patient-reported outcome (PRO) data was suspended in many cancer centers, with resulting under-recognition of anxiety and depression in ambulatory patients. As in many other areas, disparities in delivery of supportive and palliative care were magnified by the pandemic.

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Section: Widespread Adoption Of Telemedicinementioning

confidence: 99%

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

Kazazian

Swallow

2022

Current Opinion in Supportive &Amp; Palliative Care

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“…An advantage of telehealth is that the technology endorses patients’ access to care and improves their contact with HCPs, thus providing them with a support system at home [ 42 , 46 , 66 , 69 , 72 , 74 , 76 - 78 , 80 ], leading to feelings of security, safety, and closeness and connectedness with HCPs [ 46 , 52 , 66 , 76 ]. Just knowing that HCPs were available and looking out for them was emphasized by patients as important, reassuring, and meaningful [ 48 , 52 , 67 , 72 , 74 , 76 ].…”

Section: Resultsmentioning

confidence: 99%

“…One of the advantages of telehealth was that, over time, the remote interaction using videoconferences’ visual cues enabled patients to acquaint with the HCPs and build supportive and trusting interpersonal relationships with them [ 42 , 47 , 48 , 50 , 75 , 76 ]. Patients perceived that such relationships improved HCPs’ understanding of their care needs [ 42 , 48 , 76 , 78 ] and that a close connection with HCPs promoted patients’ feelings of being valued as unique persons and, to some extent, alleviated a sense of loneliness [ 47 ]. Patients experienced that HCPs provided emotional support and showed empathy via videoconferences by assessing their unique situations and visibly (verbally and nonverbally) responded to emotions, choosing considered care interventions over pity [ 42 , 80 ].…”

Section: Resultsmentioning

confidence: 99%

Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: Systematic Mixed Studies Review

Steindal¹,

Nes²,

Godskesen³

et al. 2023

J Med Internet Res

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Background Owing to the increasing number of people with palliative care needs and the current shortage of health care professionals (HCPs), providing quality palliative care has become challenging. Telehealth could enable patients to spend as much time as possible at home. However, no previous systematic mixed studies reviews have synthesized evidence on patients’ experiences of the advantages and challenges of telehealth in home-based palliative care. Objective In this systematic mixed studies review, we aimed to critically appraise and synthesize the findings from studies that investigated patients’ use of telehealth in home-based palliative care, focusing on the advantages and challenges experienced by patients. Methods This is a systematic mixed studies review with a convergent design. The review is reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A systematic search was performed in the following databases: Allied and Complementary Medicine Database, CINAHL, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Health Sciences Literature, MEDLINE, PsycInfo, and Web of Science. The inclusion criteria were as follows: studies using quantitative, qualitative, or mixed methods; studies that investigated the experience of using telehealth with follow-up from HCPs of home-based patients aged ≥18; studies published between January 2010 and June 2022; and studies published in Norwegian, Danish, Swedish, English, Portuguese, or Spanish in peer-reviewed journals. Five pairs of authors independently assessed eligibility of the studies, appraised methodological quality, and extracted data. The data were synthesized using thematic synthesis. Results This systematic mixed studies review included 41 reports from 40 studies. The following 4 analytical themes were synthesized: potential for a support system and self-governance at home; visibility supports interpersonal relationships and a joint understanding of care needs; optimized information flow facilitates tailoring of remote caring practices; and technology, relationships, and complexity as perpetual obstacles in telehealth. Conclusions The advantages of telehealth were that patients experience a potential support system that could enable them to remain at home, and the visual features of telehealth enable them to build interpersonal relationships with HCPs over time. Self-reporting provides HCPs with information about symptoms and circumstances that facilitates tailoring care to specific patients. Challenges with the use of telehealth were related to barriers to technology use and inflexible reporting of complex and fluctuating symptoms and circumstances using electronic questionnaires. Few studies have included the self-reporting of existential or spiritual concerns, emotions, and well-being. Some patients perceived telehealth as intrusive and a threat to their privacy at home. To optimize the advantages and minimize the challenges with the use of telehealth in home-based palliative care, future research should include users in the design and development process.

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“…Additional concerns arose explicitly in cancer patients receiving palliative care, especially given the high symptom burden among patients, the delicate nature of goals of care conversations, and the support patients and their families often need at this vulnerable time. Palliative care services worldwide played a vital role during the COVID-19 pandemic, and telemedicine allowed for continued care to patients and their families [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Best Practices for Providing Patient-Centered Tele-Palliative Care to Cancer Patients

Aldana

Evoh

Reddy

2023

Cancers

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Cancer patients receiving palliative care may face significant challenges in attending outpatient appointments. Patients on controlled substances such as opioids require frequent visits and often rely on assistive devices and/or a caregiver to accompany them to these visits. In addition, pain, fatigue, and shortness of breath may magnify the challenges associated with in-person visits. The rapid adoption of telemedicine in response to the COVID-19 pandemic has proven to be highly beneficial for advanced cancer patients and caregivers. The hurried COVID-19-related implementation of telemedicine is now evolving into a permanent platform for providing palliative care. This review will focus on the best practices and recommendations to deliver high-quality, interdisciplinary tele-palliative care.

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Experiences with Telehealth for Outpatient Palliative Care: Findings from a Mixed-Methods Study of Patients and Providers across the United States

Cited by 21 publications

References 31 publications

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

Impact of the coronavirus disease 2019 pandemic on delivery of and models for supportive and palliative care for oncology patients

Advantages and Challenges of Using Telehealth for Home-Based Palliative Care: Systematic Mixed Studies Review

Best Practices for Providing Patient-Centered Tele-Palliative Care to Cancer Patients

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