Palliative care for adult patients with non-curable non-small cell lung cancer (NSCLC) leads to equivalent benefits for patient reported quality of life, whether delivered via video or in person visits, the REACH PC trial demonstrated.
Many patients with advanced, non-curable lung cancer report both physical, mental, and sometimes financial issues leading to poor quality of life. Therefore, guidelines recommend the early integration of palliative and oncology care for patients with advanced cancer, given that robust evidence shows 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 potentially overcome these barriers. The randomized REACH PC trial (NCT03375489) evaluated the equivalence of the effect of delivering early palliative care using video visits versus in-person visits on patient reported quality of life in patients with advanced NSCLC (n=1,250) and their caregivers.
Patients and their caregivers were 1:1 randomly assigned to receive palliative care via monthly in person or video visits, after an initial in person visit. Patient characteristics and clinical characteristics were comparable in both groups. The primary outcome measurement was quality of life, and functional assessment of cancer therapy-lung Scale (FACT-L) was performed at at 12, 24, 36, and 48 weeks of follow up. Prof. Joseph Greer, PhD, of the Harvard Medical School, in Massachusetts, presented the results at 24 weeks of follow-up1.
Of patients in the video visit group, 66% completed 24-week FACT-L versus 69% of patients in the in-person visit group. Topics addressed during the visits did not differ between groups. Quality of life after 24 weeks, as well as satisfaction with care, anxiety, and depression scores, did not differ between groups at 24 weeks of follow up. Attendance of caregivers at the visits was significantly higher in the in person visit group (49.7% vs 36.6%).
Based on these results, Prof. Greer concluded that “the effect on quality of life of early palliative care 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.”
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