Patients with cardiac and pulmonary conditions see improvements in their quality of life after receiving palliative care via telehealth.
A randomized clinical trial with 306 participants who suffered from chronic obstructive pulmonary disease (COPD), heart failure (HF), and interstitial lung disease (ILD) found that palliative telehealth resulted in significant improvements. The results were published in the Journal of the American Medical Association.
“For adults with COPD, HF, or ILD who were at high risk of death and had poor quality of life, a nurse and social worker palliative telecare team produced clinically meaningful improvements in quality of life at six months compared with usual care,” the study authors indicated.
The four-year study took place in two U.S. Veterans Administration health care systems, one in Colorado and another in Washington state. Participants in the study received six phone calls with a nurse to help with symptom management and six with a social worker to address psychosocial needs.
These nurses and social workers met weekly with primary care and palliative care physicians, as well as a pulmonologist, and cardiologist as needed.
Similar results have occurred among patients with Parkinson’s Disease and acute psychological needs, other research has found.
While these results show promise, the unique nature of the veteran population represents a limitation, according to Marian Grant, senior regulatory advisor to the Coalition to Transform Advanced Care (C-TAC).
For example, nearly 90% of the study participants were white males, though many were Hispanic as well.
“This is a test of the power of some of the elements of palliative care. But this was done in the VA, and the VA is a wonderful environment for palliative care. They have systematic advanced care planning. They have palliative care available in all of their hospitals. They offer concurrent care for hospice,” Grant told Palliative Care News. “So this is not your average health system doing this intervention. You can’t generalize this and say that any nurse and social worker calling patients with these illnesses would get the same results.”
However, the future of telehealth remains uncertain. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire.
In a recent hearing before the U.S. House Ways and Means Committee U.S. Health and Human Services (HHS) Secretary Xavier Becerra said that the federal government was willing to make them permanent. However, he said this would require closer collaboration with state governments.
“We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said. “Right now, because states decide who gets licensed to do care, we have to have the cooperation of the states so we can go beyond its own state borders.”
