School of nursing, Shanxi Medical University, Shanxi Province, China.
Department of Neurology, First Hospital of Shanxi Medical University, Shanxi Province, China.
Am J Hosp Palliat Care. 2023 Aug;40(8):907-925. doi: 10.1177/10499091221123566. Epub 2022 Sep 14.
To describe the use of tele-palliative care in patients with advanced disease and assess its effectiveness on quality of life (QOL), symptom burden and other outcomes for patients and their caregivers. We searched for randomised controlled trials to assess the outcomes of tele-palliative care on patients with advanced disease and their caregivers. Eight databases were searched for studies published in Chinese or English from inception to November 27, 2021. Data from the included trials were extracted independently by 2 reviewers and evaluated independently for methodological quality using the Cochrane Collaboration's tool. A narrative synthesis of the results of all trials was performed. Thirty trials were included ultimately with more than one half of the studies were moderate to high quality, including, which involved 19 665 patients and 1153 caregivers. Results from 10/15 included trials (reporting patient QOL), 5/14 trials (reporting patient symptoms), 1/3 trials (reporting survival), 8/13 trials (reporting patient mood), 3/6 trials (reporting ACP related indicators), 3/7 trials (reporting resource utilization) showed statistically significant between tele-palliative care and control care groups. Of 30 trials, 8 measured caregiver outcomes, 1/4 trials (reporting caregiver QOL) showed statistically significant, and results from 3/3 trials (reporting caregiver mood), 3/4 trials (reporting caregiver burden) showed benefit in at least 1 domain at 1 or more time points. This systematic review suggests that although tele-palliative care can improve patient physical, patient and caregiver psychological health outcomes to some extent, there is still a lack of sufficient evidence to substantiate its application effects. Moreever, regional and cultural characteristics should also be taken into account when tele-palliative care interventions are carried out.
描述远程姑息治疗在晚期疾病患者中的应用，并评估其对患者及其照护者生活质量（QOL）、症状负担和其他结局的影响。我们检索了随机对照试验，以评估远程姑息治疗对晚期疾病患者及其照护者的结局影响。我们检索了 8 个数据库，以获取 2021 年 11 月 27 日之前发表的中文或英文研究。由 2 名评审员独立提取纳入试验的数据，并使用 Cochrane 协作工具独立评估方法学质量。对所有试验的结果进行了叙述性综合。最终纳入了 30 项试验，其中超过一半的研究为中高质量，包括涉及 19665 名患者和 1153 名照护者的研究。来自 10/15 项纳入试验（报告患者 QOL）、5/14 项试验（报告患者症状）、1/3 项试验（报告生存）、8/13 项试验（报告患者情绪）、3/6 项试验（报告 ACP 相关指标）、3/7 项试验（报告资源利用）的结果显示远程姑息治疗与对照组之间存在统计学显著差异。在 30 项试验中，有 8 项测量了照护者结局，1/4 项试验（报告照护者 QOL）显示有统计学意义，3/3 项试验（报告照护者情绪）、3/4 项试验（报告照护者负担）的结果显示至少在 1 个或多个时间点在 1 个或多个领域有获益。本系统评价表明，尽管远程姑息治疗在一定程度上可以改善患者的身体、患者和照护者的心理健康结局，但仍缺乏足够的证据来证实其应用效果。此外，在开展远程姑息治疗干预时，还应考虑到区域和文化特征。
