JMIR Publications

ABSTRACT

Background:

Telehealth is increasingly used to support symptom management in home-based palliative care. However, evidence regarding the specific components of telehealth and their effects remains fragmented and has not been comprehensively synthesized. A clearer understanding of how telehealth components contribute to symptom management and patient- and care-related outcomes is needed to inform the development of effective and patient-centered home-based palliative care models.

Objective:

To identify the core components of telehealth used for symptom management and synthesize evidence on their effects in home-based palliative care.

Methods:

Ten databases (CINAHL, Cochrane Library, EMBASE, PsycINFO, PubMed, Scopus, Web of Science, CNKI, Wanfang, and VIP) were searched from inception to July 2026. Eligible studies included quantitative, qualitative, and mixed-methods research evaluating telehealth interventions for symptom management or exploring related experiences in home-based palliative care. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Findings were synthesized using the JBI convergent segregated approach and integrated deductively under the Symptom Management Theory.

Results:

Thirty-seven eligible studies (5 qualitative, 15 quantitative, and 17 mixed methods) were included. Core symptom management components comprised symptom monitoring, self-reporting tools, alerts, virtual consultations, and management strategies, most of which were delivered via mobile or web-based platforms. Quantitative findings regarding symptom severity and quality of life were mixed, whereas usability and feasibility were generally favorable, with moderate-to-high adherence and patient satisfaction reported across studies. Qualitative findings yielded 6 themes: Symptom experience: i) Enhancing patient confidence and assurance in symptom care; ii) The tech-induced struggles in symptom care; Symptom management: iii) Telehealth streamlines delivery of symptom management at home; iv) Lack personal care and physical proximity when managing symptom remotely; Symptom outcomes: v) Improved patients’ performance and satisfaction; vi) Improved end-of-life care quality. Integrated evidence suggested that telehealth-supported symptom management is facilitated by timely responsiveness and patient engagement, while its potential benefits depend on usability, adherence, and the linkage between symptom monitoring and actionable clinical responses. These findings indicate that the clinical value of telehealth may extend beyond direct symptom reduction to include improved access to professional support and continuity of care.

Conclusions:

This review advances understanding of telehealth in home-based palliative care by showing its value of remote access to care. Telehealth can establish a longitudinal symptom-management pathway that links monitoring, alerts, and clinical responses, thereby enhancing responsiveness, continuity, and caregiver support. However, improvements in these care processes do not necessarily translate into better symptom or quality-of-life outcomes, particularly in the context of progressive and advanced illness. Telehealth is therefore best positioned as a complement to face-to-face palliative care, with hybrid models potentially offering greater flexibility across the end-of-life trajectory. Future research should prioritize patient-centered and context-sensitive intelligent systems that reduce reporting burden, generate clinically actionable alerts, and facilitate timely escalation between remote and in-person care. Clinical Trial: Funding: Beijing Municipal Commission of Education Basic Scientific Research Operating Expenses–Start-up Grant for New Faculty (2025) [XJJS202532]. Registration: PROSPERO (registration number: CRD42023463939: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023463939)