A recent large-scale trial has shown that telehealth delivery of early palliative care (EPC) is as effective as in-person visits for patients with advanced non-small cell lung cancer (NSCLC). The study, conducted between June 2018 and May 2023 across 22 cancer centres in the US, enrolled 1,250 patients and aimed to compare the quality of life (QOL) outcomes between telehealth and in-person EPC.
Participants, diagnosed within the past 12 weeks, were randomly assigned to either telehealth or in-person EPC. They met with palliative care clinicians every four weeks and completed self-reported measures at baseline, 12 weeks, and 24 weeks. The primary measure was the Functional Assessment of Cancer Therapy-Lung (FACT-L) to evaluate QOL.
Results indicated that QOL scores at 24 weeks were equivalent between the telehealth and in-person groups, with adjusted means of 99.67 and 97.67 respectively (p < 0.043). The average number of palliative care encounters was similar, with 4.75 for telehealth and 4.92 for in-person. Despite the pandemic causing 3.9% of in-person visits to switch to video, the equivalence in QOL was maintained.
However, caregiver participation was significantly lower in the telehealth group (36.6%) compared to the in-person group (49.7%, p < 0.0001). There were no significant differences in patient-reported depression, anxiety, coping skills, or perceptions of treatment goals and curability.
This study highlights the potential of telehealth to enhance access to EPC for patients with advanced cancer, suggesting that remote care can effectively maintain QOL. These findings may encourage broader implementation of telehealth palliative care, addressing the accessibility challenges faced by many patients.
Reference:
Greer J et al. Comparative effectiveness trial of early palliative care delivered via telehealth versus in person among patients with advanced lung cancer. ASCO 2024.
