Virtual palliative care confers quality of life improvements in advanced NSCLC

Telehealth delivery of early palliative care positively affects quality of life in patients with advanced non–small cell lung cancer (NSCLC) the same way an in-person delivery does, according to a study.

Within 12 weeks of diagnosis of advanced NSCLC, patients were randomly assigned to meet with a specialty-trained palliative care clinician every 4 weeks either via video call or in person in the outpatient clinic throughout the course of disease. Patients in the video group had to initially meet the clinician in person in order to establish rapport, followed by subsequent virtual consultations.

A total of 1,250 patients and 548 caregivers (mean age 65.5 years, 54.0 percent women, 82.7 percent White) were included in the analysis. The main outcome was the equivalence of the effect of virtual vs in-person early palliative care on quality of life at week 24 based on 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). Both patients and caregivers completed study questionnaires at enrolment and at weeks 12, 24, 36, and 48.

At 24 weeks, a mean of 4.7 virtual and 4.9 in-person early palliative care encounters were recorded. Patient-reported quality-of-life scores were equivalent between the virtual group and the in-person group (mean, 99.7 vs 97.7; difference, 2.0, 90 percent confidence interval, 0.1–3.9; p=0.04 for equivalence).

Meanwhile, caregiver participation was much lower on virtual than in in-person early palliative care (36.6 percent vs 49.7 percent; p<0.001).

There were no differences seen in caregiver quality of life, patient coping, or patient and caregiver satisfaction with care, mood symptoms, or prognostic perceptions between the virtual and in-person group.