Examining the Influence of Video-Based Palliative Care on Quality of Life
A recent study, named REACH-PC, illustrated that early palliative care provided through video consultations produced similar advantages to traditional face-to-face visits in improving quality-of-life measures for individuals with advanced lung cancer.
The study also revealed that levels of patient and caregiver contentment, as well as reported symptoms of anxiety and depression among patients, did not display significant variances between those undergoing video consultations and those selecting in-person interactions for their palliative care.
Joseph A. Greer, PhD, from Massachusetts General Hospital and Harvard Medical School, emphasized the crucial discovery that palliative care, regardless of the delivery mode (video or in-person), had comparable positive impacts on patient-reported quality of life for adults confronting advanced lung cancer.
Enhancing Palliative Care Accessibility through Telehealth
Presenting at the American Society of Clinical Oncology (ASCO) annual meeting, Greer highlighted the opportunity to expand access to evidence-based early palliative care through telehealth services.
The research assessed quality of life using the Adjusted Mean Functional Assessment of Cancer Therapy-Lung (FACT-L) scale, with scores above 4 indicating enhanced quality of life. Results at 24 weeks demonstrated similar scores between the video and in-person groups, meeting the criteria for equivalence (P=0.04).
Both groups expressed similar levels of satisfaction with care, with around 40% of patients and caregivers reporting satisfaction. Additionally, anxiety and depression scores were comparable across the two groups.
Interestingly, the attendance of caregivers was higher in the in-person visit group compared to the video visit group, indicating a preference for physical visits (P<0.001).
Utilizing Technology for Improved Palliative Care
Charu Agarwal, MD, MPH, from the University of Pennsylvania, emphasized the potential of technology in making palliative care more accessible and reducing the burden on patients.
Many individuals with metastatic lung cancer face challenging physical and psychological symptoms that affect their quality of life. National guidelines recommend early integration of palliative care in the management of advanced cancer to address these issues.
Greer emphasized the importance of early palliative care in enhancing quality of life, mood symptoms, and coping mechanisms for individuals with advanced cancer. However, limited availability of specialized palliative care providers and practical obstacles hinder access to such care for numerous patients.
Embracing Telehealth for Enhanced Patient Outcomes
The use of telehealth has increased following the COVID-19 pandemic, providing a viable solution to overcome barriers to accessing palliative care. Telehealth has proven effective in improving access to supportive oncology services and reducing healthcare costs for cancer patients.
To assess the effectiveness of video consultations in improving patient outcomes, Greer and his team conducted a comparative effectiveness trial comparing video-based and in-person palliative care for individuals with advanced non-small cell lung cancer.
The study, which enrolled 1,250 patients and 548 caregivers, randomly assigned participants to receive monthly video or in-person visits for early palliative care. Quality of life assessments were conducted every 12 weeks over a 48-week period.
Palliative care visits typically involve symptom management, psychological support, and coping strategies, whether delivered through telehealth platforms or in face-to-face settings.
Future Implications and Research Directions
The findings of the study aim to guide future policy decisions regarding coverage of virtual care. Video consultations can alleviate travel burdens, costs, and infection risks for vulnerable patients, although the necessity of in-person visits remains to be determined.
Further research is needed to ensure diverse patient representation and analyze intervention effects across various subgroups.
Disclosures
The REACH-PC trial received funding from the Patient-Centered Outcomes Research Institute.
Greer disclosed relationships with BeiGene, Blue Note Therapeutics, NCCN/AstraZeneca, Oxford University Press, and Springer Publishing.
Primary Source
American Society of Clinical Oncology
Source Reference: Greer JA, et al “Comparative effectiveness trial of early palliative care delivered via telehealth versus in person among patients with advanced lung cancer” ASCO 2024; Abstract LBA3.
