Feasibility, acceptability and needs in telemedicine for palliative care

Abstract

BACKGROUND: Telemedicine in palliative care was initially developed in countries where geography or resources limit access to care services. Recently, largely owing to the COVID-19 pandemic, this technology is being increasingly used in highly urbanised countries such as Switzerland. However, there is still scepticism regarding whether these tools can be used effectively in palliative care, a relationship-based speciality that is generally highly dependent on compassion, communication and direct human interaction. The objective of this review was to analyse the needs, elements of feasibility, and reasons for acceptance or possible barriers before the implementation of a telemedicine intervention in Switzerland. METHODS: The method used was a scoping review, following the PRISMA-ScR reporting guidelines. We searched the PubMed, Ovid SP, Medline, Cochrane and Scopus databases for relevant reports. Charting and analyses of the data were done by a single researcher. A total of 520 records were screened and assessed for eligibility. Finally, 27 studies and 4 registry entries were included. Main reasons for exclusion were wrong population and intervention. RESULTS: The prevailing study type was the single-arm intervention study. Most studies originated from countries with geographic barriers to access. Feasibility was good in 69% of all studies. Good acceptability (84.1–100%) was confirmed in the majority of the studies. The needs of the patients or the healthcare professionals were directly addressed in only five (16%) studies. Three needs were consistently reported: communication, coordination and technical reliability CONCLUSION: Despite a broad range of studies on telemedicine in palliative care, patients’ needs are rarely addressed. Therefore, especially in countries such as Switzerland, a needs assessment is recommended before the implementation of a new telemedicine intervention, to guarantee high feasibility and acceptability.

Palliative care and COVID-19: a bibliometric analysis

“…It is not surprising that ‘telemedicine’ and ‘telehealth’ appeared as keywords tightly connected with the words ‘geriatrics’ and ‘social isolation’ but also to ‘cancer’. There is clear evidence that telemedicine has become more and more important during the pandemic to overcome the barrier of the COVID-19 restrictions for patients 19 20. Often, patients with advanced disease have difficulties due to mobility issues, high symptoms burden and dependency on caregivers for in-patient visits.…”

Telemedizin in der Palliativversorgung

“…Bedenken gibt es hinsichtlich der Sicherheitsaspekte [13]. Es könnte zu Datenschutzverletzungen kommen und zu Persönlichkeitsverletzungen durch unerlaubten Zugriff fremder Personen auf eine Videokonferenz oder auf medizinische Unterlagen.…”

“…Die Stabilität der Internetverbindung ist ein kritischer Aspekt, der von Anwenderseite geäußert wurde [13]. Technische Probleme werden weiterhin als Grenzen der telemedizinischen Versorgung angegeben.…”

“…Häufig wird in der Palliative Care über den Einsatz von Videokonferenzen zur Patientenversorgung berichtet. Die meisten klinischen Studien beziehen sich auf Anwendungen im ambulanten Bereich 13 . Wie im genannten Fallbeispiel ergänzen Videokonferenzen eine bestehende Versorgung und erweitern sie um eine zusätzliche fachspezifische Kompetenz, oder sie ersetzen eine bestehende Versorgung.…”

Rural Palliative Care Telemedicine for Advanced Cancer Patients: A Systematic Review

“…10 It has been challenged if palliative care telemedicine can meet the needs of advanced cancer patients despite the acceptance and feasibility of this modality of care. 11 A review of 6 systematic reviews indicates that palliative care telemedicine offers patients unable to access conventional care, an alternative way to achieve symptom control, quality of life improvement, and lower health care costs. 12 Rogante et al 12 points that despite the benefits of palliative care telemedicine, the heterogeneity of strategies assessed in the original studies precludes a holistic model of rural palliative care telemedicine that may become an universal standard with proven usefulness.…”