Travel burden and telemedicine in home-based palliative care: potential and limitations - prospective analysis

To assess clinicians' travel burden in home-based palliative care (PC), identify factors improving the telemedicine (TM) applicability and assess its perceived feasibility.

This prospective, multicentre, real-world study analysed outpatient visits with oncological patients. It assessed travel and time burden, patient and visit characteristics, perception of both patients and clinicians regarding TM. Statistical analyses were performed to describe the data and evaluate associations between variables.

Based on 311 recorded visits in July 2025, travel time reaching patients' home was 7071 min, visit time was 14 177 min, distance travelled was 4411.85 km. The agreement between clinicians and patients on TM feasibility had a concordance rate of 76.20% (κ=0.55). In these cases, the potential savings were 1493 min on travel time, 2353 min of visit time and 984.6 km in distance. First-time and unscheduled visits were significantly longer than follow-up (p<0.001). Visit time was also significantly longer with uncontrolled symptoms (p=0.0419), higher median PERSONS score or significant therapeutic changes (p<0.001). Multivariate analysis confirmed that expected clinical complexity, type of visit, presence of significant symptoms and target symptom (only for clinicians) were the strongest predictors of TM practicability.

TM could reduce travel burden, but it is feasible in selected cases. Future efforts should focus on identifying patient subgroups for whom TM could safely and effectively replace in-person home visits. Stratifying patients may help optimise resource allocation and guide personalised care models in home-based PC.