JMIR Publications

ABSTRACT

Background:

Due to the increasing number of people with palliative care needs and the current shortage in the health care professional workforce, providing quality palliative care has become a greater challenge. Telehealth could enable patients to spend as much time as possible at home. However, no previous systematic mixed studies reviews have synthesized evidence on patients’ experiences of the advantages and challenges of telehealth for home-based palliative care.

Objective:

This systematic mixed studies review aimed to critically appraise and synthesize the findings from studies that investigated patients’ use of telehealth in home-based palliative care, focusing on the advantages and challenges experienced by patients.

Methods:

This is a systematic mixed studies review with a convergent design. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. A systematic search was performed in the following databases: Allied and Complementary Medicine Database (AMED), the Cumulative Index to Nursing and Allied Health (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL), the Excerpta Medica Database (EMBASE), Literature in the Health Sciences in Latin America and the Caribbean (LILACS), Medical Literature Analysis and Retrieval System Online (Medline), PsycINFO, and the Web of Science. The inclusion criteria were the following: 1) studies using quantitative, qualitative, or mixed methods; 2) studies on the experience of using telehealth with follow-up from health care professionals of home-based patients aged 18 years and older, 3) studies published between January 2010 and June 2022, and 4) studies published in Norwegian, Danish, Swedish, English, Portuguese, and Spanish in peer-reviewed journals. Pairs of authors independently assessed eligibility, appraised methodological quality, and extracted data. The data were synthesized using thematic synthesis.

Results:

This systematic mixed studies review included 41 reports from 40 studies. Four analytical themes were synthesized: Potential for a support system and self-governance at home; visibility supports interpersonal relationships and joint understanding of care needs; optimized information flow facilitates tailoring of remote caring practices; and technology, relationships, and complexity as perpetuated obstacles in telehealth.

Conclusions:

The advantages of telehealth were that patients experience telehealth as a potential support system that enables them to remain at home; the visual features of telehealth enable patients to build interpersonal relationships with health care professionals over time, and self-reporting provides health care professionals with information about symptoms and circumstances that health care professionals facilitated tailoring care to specific patients. Challenges with the use of telehealth were related to barriers in technology use, and inflexible reporting of complex and fluctuating symptoms and circumstances using electronic questionnaires.