Research Spotlight: Assessing the Effectiveness of Telehealth-Based Palliative Care Services for Patients with Advanced Lung Cancer

Joseph Greer, PhD, and Jennifer Temel, MD, the co-directors of the Cancer Outcomes Research and Education Program at Massachusetts General Hospital, are the lead authors of a new study in JAMA; Telehealth Versus In-Person Early Palliative Care for Patients with Advanced Lung Cancer: A Multisite Randomized Clinical Trial.

Vicki Jackson, MD, MPH, chief of Palliative Care at Massachusetts General Hospital, is senior author of the study.

What Question Were You Investigating with This Study?

National guidelines recommend the early involvement of specialty-trained palliative care clinicians as the standard of care for patients with advanced lung cancer. However, most patients do not receive this care due to palliative care workforce shortages and other access barriers.

Can we use telehealth (video visits) to deliver effective palliative care for patients with advanced cancer?

What Did You Find?

In this large-scale comparative effectiveness trial, we demonstrated the equivalence of the effect of delivering early palliative care via video versus in-person visits on quality of life in patients with advanced lung cancer.

The trial included 1,250 patients, with 633 in the video visit palliative care group and 617 in the in-person palliative care group.  There were also 548 caregivers (i.e., a family member or friend who was involved in the patient’s care) enrolled in the study.

All patients who participated in the study received early palliative care that began soon after their diagnosis and continued throughout the course of their disease and treatment.

Patients in both study groups had contact with the palliative care clinician every four weeks, with the visits occurring predominantly in clinic for those randomly assigned to in-person palliative care and via video visits for those assigned to telehealth palliative care.

The palliative care clinicians addressed the same topics in both study groups, which focused on physical and psychological symptoms, coping, illness understanding, care preferences, and treatment decisions. The patients’ caregivers were also invited to attend the palliative care visits in both study groups, though this participation was voluntary.

What are the Next Steps?

We will examine whether certain subgroups of patients benefited more or less from video visit versus in-person palliative care. For example, we will evaluate whether younger or more computer-experienced patients benefited more compared with older or less computer-savvy patients.

We also plan to examine the effect of both video visit and in-person palliative care on the quality of patients’ end-of-life care, including their communication with clinicians about their care preferences.

Funding:

This study was funded by the Patient-Centered Outcomes Research Institute.

Paper Cited

Greer JA, Temel JS, El-Jawahri A, et al. Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical Trial. JAMA. Published online September 11, 2024. doi:10.1001/jama.2024.13964