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Gregory J. Riely, MD, PhD
Gregory J. Riely, MD, PhD
Posted: Wednesday, June 5, 2024
Although early palliative and oncology care is recommended for patients with advanced cancer, most do not receive such intervention in the outpatient setting because of limited access and resources. Thus, Joseph A. Greer, PhD, of Massachusetts General Hospital, Boston, and colleagues conducted a large-scale comparative effectiveness trial of secure video vs in-person early palliative care among those with non–small cell lung cancer (NSCLC) and their caregivers. The results, which were presented during the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract LBA3), underscore the potential of telehealth for improving access to and broader dissemination of this evidence-based care model.
“Video vs in-person visits demonstrated equivalent effects on quality of life,” the investigators remarked. “The two modalities also did not differ across a range of patient-reported outcomes, though caregivers attended more in-person vs video visits.”
Between June 2018 and May 2023, a total of 1,250 patients who were diagnosed within 12 weeks before enrollment were randomly assigned to meet with a palliative care clinician every 4 weeks via video or in an outpatient clinic. At baseline and weeks 12 and 24, they completed self-report measures. The patients had a mean of 4.8 and 4.9 telehealth and in-person visits, respectively, by week 24. Because of the COVID-19 pandemic, 3.9% of the assigned in-person visits were conducted via video.
Patients who received telehealth vs in-person intervention demonstrated equivalent 24-week quality-of-life scores (adjusted means, 99.7 vs 97.7; P < .043). The rate of caregiver participation was lower with telehealth delivery (36.6% vs 49.7%; P < .0001). Depression and anxiety symptoms, the use of coping skills, and perceptions of the goal of treatment and curability were not found to differ between the groups.
related abstract on the same study but a different arm, which was conducted by Jennifer S. Temel, MD, also of Massachusetts General Hospital, and colleagues and presented during the meeting (Abstract 12000), evaluated a stepped palliative care approach. The model offers a potentially more scalable avenue for delivering such early intervention in this setting.
Disclosure: For full disclosures of the study authors, visit coi.asco.org.
