Telehealth Palliative Care in Nursing Homes: A Scoping Review |
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| Institution: | 1. Nursing Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;2. Hospital de la Santa Creu i Sant Pau, Barcelona, Spain;3. Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain;4. Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), Barcelona, Spain;5. Universitat Autònoma de Barcelona, Barcelona, Spain;6. CIBER de Epidemiología y Salud Pública (CIBERESP). Spain;7. Sant Pau Biomedical Research Institute (IIB Sant Pau), Barcelona, Spain;2. Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, Georgia;3. Department of Neurology, Medical College of Georgia, Augusta University, Augusta, Georgia;4. Department of Neurology, Medical College of Georgia, Augusta University, Augusta, Georgia;5. Department of Public Health Sciences, Clemson University, Clemson, South Carolina;1. Department of Biotechnology, Biyani Girls College, Jaipur, Rajasthan, India;2. Department of Botany, University of Rajasthan, Jaipur, Rajasthan, India;3. Department of Genomic Center, Bioinformatics, All India Institute of Medical Sciences, New Delhi, India;4. School of Biology, MIT World Peace University, Pune, Maharashtra, India;5. School of Humanities, Mohanlal Sukhadia University, Udaipur, Rajasthan, India;6. Department of Bioscience and Biotechnology, Japan Advanced Institute of Science and Technology, Ishikawa, Japan |
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| Abstract: | ObjectivesMany adults older than 65 spend time in a nursing home (NH) at the end of life where specialist palliative care is limited. However, telehealth may improve access to palliative care services. A review of the literature was conducted to synthesize the evidence for telehealth palliative care in NHs to provide recommendations for practice, research, and policy.DesignJoanna Briggs Institute guidance for scoping reviews, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews frameworks were used to guide this literature review.Settings and ParticipantsReviewed articles focused on residents in NHs with telehealth palliative care interventionists operating remotely. Participants included NH residents, care partner(s), and NH staff/clinicians.MethodsWe searched Medline (Ovid), Embase (Elsevier), Cochrane Library (WileyOnline), Scopus (Elsevier), CINHAL (EBSCOhost), Trip PRO, and Dissertations & Theses Global (ProQuest) in June 2021, with an update in January 2022. We included observational and qualitative studies, clinical trials, quality improvement projects, and case and clinical reports that self-identified as telehealth palliative care for NH residents.ResultsThe review yielded 11 eligible articles published in the United States and internationally from 2008 to 2020. Articles described live video as the preferred telehealth delivery modality with goals of care and physical aspects of care being most commonly addressed. Findings in the articles focused on 5 patient and family-centered outcomes: symptom management, quality of life, advance care planning, health care use, and evaluation of care. Consistent benefits of telehealth palliative care included increased documentation of goals of care and decrease in acute care use. Disadvantages included technological difficulties and increased NH financial burden.Conclusions and ImplicationsAlthough limited in scope and quality, the current evidence for telehealth palliative care interventions shows promise for improving quality and outcomes of serious illness care in NHs. Future empirical studies should focus on intervention effectiveness, implementation outcomes (eg, managing technology), stakeholders’ experience, and costs. |
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| Keywords: | Telehealth palliative care nursing homes serious illness post-acute and long-term care |
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