The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer -a randomized clinical trial.

Source: Hoek et al. 2017 - Pubmed ID: 28625164

Setting: Nether-lands, University hospital and home care organi-zations

Study design:

RCT

 

Follow up: 13 weeks

Patient group:

Sample size

Total: 74 (32)

IG: 38 (15)

CG: 36 (17)

 

Inclusion criteria:

  • Advanced cancer with less than 3 months to live
  • Home-dwelling
  • Have a GP who agrees to participate
Type of technology:

App

  • Computer
  • IPad with video
  • Audio app
  • Microphone
  • Camera
  • Problem solving
  • Needs
  • Treatment
Intervention:

Intervention: Teleconsultations from a hospital-based specialist palliative care consultation team (SPCT) effect on patient-experienced symptom burden. Initial assessment either at the outpatient clinic or at home. Weekly prescheduled teleconsultations with an SPCT-member. Participants could not directly contact the SPCT members through teleconsultation. The participant’s GP was invited to visit and join the patient during the teleconsultation appointments


Duration
: 13 weeks
Add on: NA 

 

Control group: Usual care

Clinical effect/ Patient safety:

Clinical effect:

  • Total Distress Score↑
  • HADS-anxiety↑
  • HADS-depression→
  • Unmet palliative care needs→
  • Satisfaction with teleconsultations→
  • Burden experienced by informal caregivers→

Patient safety: NA

Patient experiences/ Staff experiences:

Patient experiences:

  • Total Distress Score↑
  • HADS-anxiety↑
  • HADS-depression→
  • Unmet palliative care needs→
  • Satisfaction with teleconsultations→
  • Burden experienced by informal caregivers→

 

Staff experiences: NA

Costs and organization:

Investment:
Equipment

  • Teleconsultation system

 

Running:
Equipment

  • Teleconsultation system

Staff

  • Home assessment
  • Technical instalation
  • Adjustments

 

Organization:

  • Collaboration between hospital and primary care

 

Health care utilization:

  •  Continuity of care→
  • Hospital admissions→
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Information

“↑”: Statistically significant increase

“↓”: Statistically significant decrease

“→”: Statistically insignificant (no difference)