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Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical

Joseph A Greer1,2, Jennifer S Temel2,3, Areej El-Jawahri2,3

  • 1Department of Psychiatry, Massachusetts General Hospital, Boston.

JAMA
|September 11, 2024
PubMed
Summary

Early palliative care via video visits is as effective as in-person visits for improving quality of life in advanced non-small cell lung cancer patients. This telehealth approach enhances access to crucial supportive care.

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Area of Science:

  • Oncology
  • Palliative Care
  • Health Services Research

Background:

  • Early palliative care significantly improves quality of life for advanced cancer patients and their caregivers.
  • Access to evidence-based palliative care remains a challenge for many patients.

Purpose of the Study:

  • To determine if secure video palliative care visits are equivalent to in-person visits for advanced non-small cell lung cancer (NSCLC) patients.
  • To assess the impact on patient quality of life.

Main Methods:

  • A randomized, multisite comparative effectiveness trial involving 1250 patients with advanced NSCLC and 548 caregivers.
  • Patients received palliative care every 4 weeks via video or in-person visits.
  • Quality of life was measured using the Functional Assessment of Cancer Therapy-Lung questionnaire at multiple time points.

Main Results:

  • Patient-reported quality of life scores were equivalent between video and in-person palliative care groups at 24 weeks (mean difference 2.0 points).
  • Caregiver participation was lower in the video visit group (36.6%) compared to the in-person group (49.7%).
  • No significant differences were observed in caregiver quality of life, patient coping, satisfaction, mood, or prognostic perceptions between the groups.

Conclusions:

  • Virtual delivery of early palliative care is equivalent to in-person delivery for improving quality of life in advanced NSCLC patients.
  • Telehealth offers a promising avenue to expand access to this vital care model.
  • Further research may explore strategies to enhance caregiver engagement in virtual palliative care settings.