Academic Journal
Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical Trial.
| العنوان: | Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer: A Multisite Randomized Clinical Trial. |
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| المؤلفون: | Greer, Joseph A.1,2 (AUTHOR) jgreer2@mgh.harvard.edu, Temel, Jennifer S.2,3 (AUTHOR), El-Jawahri, Areej2,3 (AUTHOR), Rinaldi, Simone3 (AUTHOR), Kamdar, Mihir2,3 (AUTHOR), Park, Elyse R.1,2,3 (AUTHOR), Horick, Nora K.3 (AUTHOR), Pintro, Kedie3 (AUTHOR), Rabideau, Dustin J.2,3 (AUTHOR), Schwamm, Lee4 (AUTHOR), Feliciano, Josephine5 (AUTHOR), Chua, Isaac6,7 (AUTHOR), Leventakos, Konstantinos8 (AUTHOR), Fischer, Stacy M.9 (AUTHOR), Campbell, Toby C.10 (AUTHOR), Rabow, Michael W.11 (AUTHOR), Zachariah, Finly12 (AUTHOR), Hanson, Laura C.13 (AUTHOR), Martin, Sara F.14 (AUTHOR), Silveira, Maria15,16 (AUTHOR) |
| المصدر: | JAMA: Journal of the American Medical Association. 10/8/2024, Vol. 332 Issue 14, p1153-1164. 12p. |
| مصطلحات موضوعية: | *CANCER patients, *PALLIATIVE treatment, *PATIENT satisfaction, *CAREGIVERS, *CANCER prognosis |
| مستخلص: | Key Points: Question: Does early palliative care delivered via secure video vs in person have an equivalent effect on quality of life in patients with advanced lung cancer? Findings: In this randomized comparative effectiveness trial of 1250 adults with advanced lung cancer receiving care across 22 institutions in the US, patients assigned to receive early palliative care via video visits reported quality-of-life scores at week 24 that were equivalent to those assigned to in-person palliative care. Meaning: Findings underscore the potential to increase access to evidence-based early palliative care through telehealth delivery. Importance: Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer and their caregivers, although most lack access to this evidence-based model of care. Objective: To evaluate whether delivering early palliative care via secure video vs in-person visits has an equivalent effect on quality of life in patients with advanced non–small cell lung cancer (NSCLC). Design, Setting, and Participants: Randomized, multisite, comparative effectiveness trial from June 14, 2018, to May 4, 2023, at 22 US cancer centers among 1250 patients within 12 weeks of diagnosis of advanced NSCLC and 548 caregivers. Intervention: Participants were randomized to meet with a specialty-trained palliative care clinician every 4 weeks either via video visit or in person in the outpatient clinic from the time of enrollment and throughout the course of disease. The video visit group had an initial in-person visit to establish rapport, followed by subsequent virtual visits. Main Outcomes and Measures: Equivalence of the effect of video visit vs in-person early palliative care on quality of life at week 24 per the Functional Assessment of Cancer Therapy-Lung questionnaire (equivalence margin of ±4 points; score range: 0-136, with higher scores indicating better quality of life). Participants completed study questionnaires at enrollment and at weeks 12, 24, 36, and 48. Results: By 24 weeks, participants (mean age, 65.5 years; 54.0% women; 82.7% White) had a mean of 4.7 (video) and 4.9 (in-person) early palliative care encounters. Patient-reported quality-of-life scores were equivalent between groups (video mean, 99.7 vs in-person mean, 97.7; difference, 2.0 [90% CI, 0.1-3.9]; P =.04 for equivalence). Rate of caregiver participation in visits was lower for video vs in-person early palliative care (36.6% vs 49.7%; P <.001). Study groups did not differ in caregiver quality of life, patient coping, or patient and caregiver satisfaction with care, mood symptoms, or prognostic perceptions. Conclusions and Relevance: The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC, underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. Trial Registration: ClinicalTrials.gov Identifier: NCT03375489 This randomized, multisite, comparative effectiveness trial investigates whether early palliative care delivered via video or in-person visits demonstrated equivalent effects on quality of life for patients with advanced non–small cell lung cancer and their caregivers. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: | Academic Search Index |
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