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Palliative Video Consultation and Symptom Distress Among Rural Inpatients: A Randomized Clinical Trial.

Marie A Bakitas1,2,3, Shena Gazaway2,3,4, Felicia Underwood2,5

  • 1Acute, Chronic and Continuing Care, School of Nursing, University of Alabama at Birmingham.

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Summary
This summary is machine-generated.

Culturally based palliative care video consultations did not significantly reduce symptom distress in rural hospitals. However, the intervention showed a clinically meaningful improvement in symptom scores, suggesting potential for future research in reducing healthcare inequities.

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Area of Science:

  • Rural Health
  • Palliative Care
  • Health Equity

Background:

  • Palliative care improves patient outcomes but is scarce in rural hospitals.
  • Rural populations face disparities in accessing specialized healthcare services.
  • Telehealth offers a potential solution to bridge geographical barriers in care delivery.

Purpose of the Study:

  • To evaluate the effectiveness of culturally adapted palliative care video consultations for rural inpatients.
  • To compare symptom distress, quality of life, and resource utilization between intervention and control groups.
  • To explore the impact of telehealth palliative care on patient-reported outcomes.

Main Methods:

  • A multisite, single-blind randomized clinical trial involving 209 inpatients from 3 rural hospitals.
  • Intervention group received culturally based video consultations and follow-up contacts.
  • Control group received routine hospital care; primary outcome was symptom distress change (ESAS).

Main Results:

  • No statistically significant difference in symptom distress reduction between groups at day 7.
  • The intervention group experienced a mean ESAS score change meeting minimal clinically important difference criteria.
  • No significant differences were found in quality of life or resource use.

Conclusions:

  • Culturally based palliative care video consultation did not significantly reduce symptom distress in this rural trial.
  • The observed clinically meaningful difference suggests potential benefits warranting further investigation.
  • Telehealth palliative care may help address healthcare inequities for rural, hospitalized patients.