Haydon Helen M, Lotfaliany Mojtaba, Broadbent Andrew, Snoswell Centaine L, Smith Anthony C, Brydon Julie-Ann, Caffery Liam J, Thomas Emma E
Centre for Online Health, The University of Queensland, Brisbane, Australia.
Centre for Health Services Research, The University of Queensland, Brisbane, Australia.
BMC Palliat Care. 2025 Jan 24;24(1):22. doi: 10.1186/s12904-024-01622-0.
Telehealth-facilitated models of palliative care are a patient-focused way to deliver specialist care in or closer to home for people with a life-limiting illness. Telehealth can increase access to palliative care and support people experiencing symptoms of advanced disease in their own home, reducing the discomfort of travel. This retrospective cohort study examines the activity and outcomes of a regional telehealth-facilitated palliative care service to (i) describe which patients are most likely to use telehealth; and (ii) explore possible impacts of telehealth on patient outcomes including place of death, timely access to care, responsiveness to urgent needs and pain management.
Analysis of service activity data (patient demographics, care modality, consultation frequency) and Palliative Care Outcomes Collaborative data registry (place of death, timely access to palliative care, responsiveness to urgent needs as measured by time in unstable phase, pain management) were undertaken. Outcomes were compared between patients who had no videoconsultations (n = 683) and those who had one or more videoconsultations (n = 524).
Compared to people who had no videoconsultations, those who had at least one appointment via video were: more than twice as likely to die at home and spent a shorter amount of time in the unstable phase of palliation. Mixed results were found regarding timely access to palliative care. There was no significant difference in pain management between consultation modes.
Telehealth-facilitated palliative care has multiple benefits, including the increased likelihood of fulfilling someone's wish to die at home, often their preferred place of death.
远程医疗辅助的姑息治疗模式是以患者为中心的方式，为患有危及生命疾病的患者在其家中或离家更近的地方提供专科护理。远程医疗可以增加获得姑息治疗的机会，并支持在家中出现晚期疾病症状的患者，减少出行的不适。这项回顾性队列研究考察了一项地区性远程医疗辅助姑息治疗服务的活动和结果，以（i）描述哪些患者最有可能使用远程医疗；以及（ii）探讨远程医疗对患者结局的可能影响，包括死亡地点、及时获得护理、对紧急需求的响应能力和疼痛管理。
对服务活动数据（患者人口统计学、护理方式、咨询频率）和姑息治疗结局协作数据登记处（死亡地点、及时获得姑息治疗、以不稳定期时长衡量的对紧急需求的响应能力）进行分析。比较未进行视频咨询的患者（n = 683）和进行了一次或多次视频咨询的患者（n = 524）的结局。
与未进行视频咨询的患者相比，至少进行过一次视频预约的患者在家中死亡的可能性高出两倍多，并且在姑息治疗不稳定期花费的时间更短。在及时获得姑息治疗方面发现了混合结果。咨询方式之间在疼痛管理方面没有显著差异。
远程医疗辅助的姑息治疗有多种益处，包括更有可能实现某人在家中死亡的愿望，而家中通常是他们首选的死亡地点。
