Comparable benefit of video- and in-person-delivered palliative care

Palliative care for patients with non-curable non-small cell lung cancer (NSCLC) enhances their quality-of-life, regardless of whether the treatment is delivered by video or in-person visits. This was demonstrated in the REACH PC trial.

Many patients with advanced, non-curable lung cancer report physical and mental (and sometimes financial) issues that lead to poor quality-of-life. Therefore, guidelines recommend the early integration of palliative and oncology care, given robust evidence that this care model improves quality-of-life and other important outcomes. However, most patients do not receive early palliative care in the outpatient setting, due to limited access and resources. Telehealth can overcome these barriers.

The randomised REACH PC trial (NCT03375489) evaluated the equivalence of the effect of early palliative care delivered via video versus in-person visits on patient-reported quality-of-life in adult patients with advanced NSCLC and their caregivers.

The participants (n=1,250) were 1:1 randomised to receive palliative care via monthly in-person visits or monthly video visits (after an initial in-person visit). The patient characteristics were comparable between groups. The primary outcome measurement was quality-of-life determined by FACT-L at 12, 24, 36, and 48 weeks of follow-up. Dr Joseph Greer (Harvard Medical School, MA, USA) presented interim results at 24 weeks of follow-up [1].

Of the participants in the video visit group, 66% completed 24-week FACT-L, versus 69% in the in-person visit group. Topics addressed during the visits did not differ between the groups. Quality-of-life after 24 weeks was equivalent in both groups (mean score 99.67 vs 97.67; within the equivalence margin of 4 points). Satisfaction with care, and anxiety and depression scores did also not differ between the groups at 24 weeks of follow-up. The attendance of caregivers at the visits was significantly higher in the in-person visit group (49.7% vs 36.6%; P<0.0001), likely due to required assistance with transportation.

Based on these results, Dr Greer concluded that “the effect of early palliative care on quality-of-life is equivalent whether the care is delivered in-person or by video. These findings underscore the potential to increase access to evidence-based early palliative care through telehealth delivery.”

1. Greer JA, et al. Comparative effectiveness trial of early palliative care delivered via telehealth versus in-person amongst patients with advanced lung cancer: the REACH PC trial. Abstract LBA3, ASCO Annual Meeting 2024, 31 May–4 June, Chicago, IL, USA.

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Posted on 18 July 202418 July 2024