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Background: Telepalliative care has been around for more than 2 decades. It is increasingly adopted, but the patient and family perspectives on its impact remain unclear. With the growth of telehealth during the COVID-19 pandemic, understanding these perspectives is essential for optimizing telepalliative care integration. The goal was to compile evidence on telepalliative care from the perspectives of patients and their families. A key benefit of telehealth is that it enhances patients' access to care and strengthens their communication with healthcare providers, offering them a support system while at home.1
Design and Participants: This systematic integrative review included 44 studies published from 2011 to 2022 that involved telepalliative care. It focused on patients aged 18+ and their families from various settings, ranging from hospitals to home care. Both qualitative and quantitative methods were utilized to gather patient and family feedback on the benefits and challenges of telepalliative care.
Results: The review identified five key themes:
1. The impact of COVID-19 on the expansion of telepalliative care.
2. Patients and families value enhanced access and convenience provided by telepalliative care ("Patients and families are largely accepting of telepalliative care")
3. The role of synchronous (live) and asynchronous (pre-recorded or delayed) care in symptom management.
4. The importance of integrating telepalliative care with standard care services to provide seamless transitions, especially towards the terminal phase.
5. Telepalliative care’s timing and tailoring to meet the diverse and evolving needs of patients and families, with some preferring face-to-face consultations for sensitive discussions.
Commentary: This review highlights the critical importance of balancing telepalliative care with in-person services, particularly as patient needs evolve. Though telepalliative care enhances access and convenience, certain limitations exist, including technology barriers and poor integration with community services. Future research should focus on developing models of care that combine synchronous and asynchronous solutions, and on outcome measures that reflect meaningful experiences for patients and families. This study underscores the need for personalized telepalliative care workflows that accommodate individual preferences.
Bottom Line: Telepalliative care improves access to care and patient-family satisfaction, especially when integrated with traditional care services. Early and flexible incorporation of telepalliative care into care models is recommended to meet the evolving needs of patients and families during their illness trajectory.
Reference:
Source: Bauer EH, Schultz ANØ, Brandt F, Smith AC, Bollig G, Dieperink KB. Patients and families’ perspectives on telepalliative care: A systematic integrative review. Palliative Medicine. 2024;38(1):42-56. DOI: 10.1177/02692163231217146.
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