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Effectiveness of Early Palliative Care Delivered via Telehealth
Dr. van Akkooi: Palliative care, we know, is a very important issue, and actually we think it is very much underutilized at the moment. Already many of the guidelines of our societies — for example, the ASCO guidelines — indicate that patients should be involved with palliative care already at a very early stage and not at the very end stage of their disease. They struggle with a lot of issues that can include how to tell their children; there can be issues regarding work, issues regarding finances, the many-fold issues that people have to face in their lives and especially when they’re dealing with the new diagnosis of cancer, needing to find their way and find their bearings. So, one important aspect is that palliative care is being underutilized and one important reason might be that it requires resources. It is time-consuming for the staff involved with delivering palliative care, and we simply already are struggling in oncology with our resources in that we don’t have enough funds and enough staff to deliver across oncology disciplines.
This study was a very interesting because obviously we’ve learned during COVID that telehealth is very important, but nobody had really examined if it is of the same quality as a face-to-face type of appointment and especially around palliative care, which is a sensitive topic; people would consider that maybe it is better to deliver palliative care face-to-face. So, in this case, it was a randomized study which was performed where half of the patients received regular face-to-face appointments of palliative care after the diagnosis of stage IV non–small cell lung cancer. The other half of the patients had an initial appointment to establish rapport with the people delivering the palliative care and thereafter went on to have telehealth appointments for their palliative care.
Palliative care delivered via telehealth on par with face-to-face approach
The main findings of this study were that the outcomes in terms of quality of life, anxiety, and depression were very similar between both groups and also patient satisfaction and that of their family, and friends were similar in both arms, thereby showing us that this is definitely something that is worthwhile pursuing even in the post-pandemic world we live in now. Definitely, in more rural communities where it would be a struggle for patients to come in for face-to-face visits on a regular basis, we can still continue delivering high-quality care through these means.
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