Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic

Chua, Isaac S.; Olmsted, Molly W.; Plotke, Rachel; Turk, Yael; Trotter, Chardria; Rinaldi, Simone; Kamdar, Mihir; Jackson, Vicki A.; Gallagher-Medeiros, Emily R.; El‐Jawahri, Areej; Temel, Jennifer S.; Greer, Joseph A.

doi:10.1016/j.jpainsymman.2022.08.005

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…In-person interactions were perceived as critical to building personal relationships with the palliative care team, particularly among those participants who received exclusively telehealth care. These findings contrast with a previously published study exploring palliative care clinicians’ experiences with telehealth delivery that suggested they rarely encountered rapport-building issues with telehealth visits 30. Elsewhere, a study exploring the opinions of patients attending an outpatient palliative care clinic regarding the hypothetical use of telehealth found that the majority of participants did not foresee any challenges maintaining a therapeutic relationship with their physician 31.…”

Section: Discussioncontrasting

confidence: 88%

“…These findings contrast with a previously published study exploring palliative care clinicians' experiences with telehealth delivery that suggested they rarely encountered rapport-building issues with telehealth visits. 30 Elsewhere, a study exploring the opinions of patients attending an outpatient palliative care clinic regarding the hypothetical use of telehealth found that the majority of participants did not foresee any challenges maintaining a therapeutic relationship with their physician. 31 However, in both studies, patients had at least one IPV to the palliative care clinic, which is consistent with our findings, where patients voiced that an initial in-person assessment is fundamental to establish a solid therapeutic relationship.…”

Section: Discussionmentioning

confidence: 99%

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Telehealth outpatient palliative care in the COVID-19 pandemic: patient experience qualitative study

Alcalde-Castro

Zaig

Nissim

et al. 2023

BMJ Support Palliat Care

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ObjectivesOutpatient in-person early palliative care improves quality of life for patients with advanced cancer. The COVID-19 pandemic forced a rapid shift to telehealth visits; however, little is known about how telehealth in outpatient palliative care settings should be optimised beyond the pandemic. We aimed to explore, from the perspective of patients attending an outpatient palliative care clinic, the most appropriate model of care for in-person versus telehealth visits.MethodsA qualitative study using the grounded theory method. One-on-one, semistructured qualitative interviews were conducted with 26 patients attending an outpatient palliative care clinic at a tertiary cancer centre recruited from two groups: (1) those with >1 in-person appointment prior to 1 March 2020 and >1 telehealth appointment after this date (n=17); and (2) patients who had exclusively telehealth appointments (n=9). Purposive sampling was used to incorporate diverse perspectives.ResultsOverall, participants endorsed a flexible hybrid approach incorporating both in-person and telehealth visits. Specific categories were: (1) in-person outpatient palliative care supported building interpersonal connections and trust; (2) telehealth palliative care facilitated greater efficiency, comfort and independence and (3) patient-preferred circumstances for in-person visits (preferred for initial consultations, visits where a physical examination may be required and advance care planning discussions), versus telehealth visits (preferred during periods of relative heath stability).ConclusionsThe elements of in-person and telehealth outpatient palliative care clinic visits described by patients as integral to their care may be used to develop models of hybrid outpatient palliative care delivery beyond the pandemic alongside reimbursement and regulatory guidelines.

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Section: Discussioncontrasting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Telehealth outpatient palliative care in the COVID-19 pandemic: patient experience qualitative study

Alcalde-Castro

Zaig

Nissim

et al. 2023

BMJ Support Palliat Care

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“…One can follow all the best practices recommended above and still encounter barriers with telemedicine [ 46 ]. Despite efforts of acquainting patients with technology and walking them through the process of getting ready for tele-visits, some patients can continue to experience technical difficulties with connection, sound, and video, forgetting their log-ins, and other technological hiccups [ 11 , 47 ].…”

Section: Barriers To Telemedicinementioning

confidence: 99%

Best Practices for Providing Patient-Centered Tele-Palliative Care to Cancer Patients

Aldana

Evoh

Reddy

2023

Cancers

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Cancer patients receiving palliative care may face significant challenges in attending outpatient appointments. Patients on controlled substances such as opioids require frequent visits and often rely on assistive devices and/or a caregiver to accompany them to these visits. In addition, pain, fatigue, and shortness of breath may magnify the challenges associated with in-person visits. The rapid adoption of telemedicine in response to the COVID-19 pandemic has proven to be highly beneficial for advanced cancer patients and caregivers. The hurried COVID-19-related implementation of telemedicine is now evolving into a permanent platform for providing palliative care. This review will focus on the best practices and recommendations to deliver high-quality, interdisciplinary tele-palliative care.

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“…The research was most frequently located in the United States (Bayly et al 2022;Chua et al 2022;Dhavale et al 2020;Hasson et al 2022;Mitchell et al 2022Mitchell et al , 2021Page et al 2020;Sleeman et al 2022;Sumitha et al 2022) of the included articles, followed by the United Kingdom (20-24). The remainder were conducted in India (Dhavale et al 2020;Page et al 2020;Sumitha et al 2022), Italy (Costantini et al 2020;Franchini et al 2021;Varani et al 2021), Germany (Jansky et al 2021;Tielker et al 2021), Australia (Luckett et al 2021), Canada (Wentlandt et al 2021), New Zealand (Frey and Balmer 2022), Taiwan (Chou et al 2020), and one multinational study (Dunleavy et al 2021).…”

Section: Article Overviewmentioning

confidence: 99%

The challenges for health professionals delivering palliative care in the community during the COVID-19 pandemic: An integrative review

Frey

Balmer

2023

Pall Supp Care

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Objectives The growing demand for palliative care has been accelerated due to the COVID-19 pandemic. However, providing community-based palliative care was also more difficult to do safely and faced several challenges. The goal of this integrative review was to identify, describe, and synthesize previous studies on the challenges for health professionals delivering palliative care in the community during the COVID-19 pandemic. Methods Searches were carried out on the Ovid MEDLINE, CINAHL, PsycINFO, Social Care Online, PubMed, Embase, and Expanded Academic databases. Journals typically reporting palliative care and community health studies were also searched (Palliative Medicine, Journal of Pain and Symptom Management, and Health & Social Care in the Community). All articles were peer-reviewed and published in English between December 2019 and September 2022. Results Database and hand searches identified 1231 articles. After duplicates were removed and the exclusion criteria applied, 27 articles were included in the final review. Themes in the research findings centered on 6 interconnected categories. The challenges imposed by the pandemic (lack of resources, communication difficulties, access to education and training, and interprofessional coordination), as well as the varying levels of success of the health-care responses, impacted the well-being of health professionals and, in turn, the well-being and care of patients and families. Significance of results The pandemic has provided the impetus for rethinking flexible and innovative approaches to overcome the challenges of delivering community palliative care. However, existing governmental and organizational policies require revision to improve communication and effective interprofessional collaboration, and additional resources are needed. A blended model of virtual and in-person palliative care delivery may provide the best solution to community palliative care delivery moving forward.

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Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic

Cited by 9 publications

References 39 publications

Telehealth outpatient palliative care in the COVID-19 pandemic: patient experience qualitative study

Telehealth outpatient palliative care in the COVID-19 pandemic: patient experience qualitative study

Best Practices for Providing Patient-Centered Tele-Palliative Care to Cancer Patients

The challenges for health professionals delivering palliative care in the community during the COVID-19 pandemic: An integrative review

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