Using Telehealth in End-of-Life Palliative Care: A Multimethod Randomized Controlled Trial

BACKGROUND: An estimated 4.4 million people in Europe require palliative care annually, a number expected to rise with population aging. Telepalliative care (TPC) has been practiced in various settings over the past two decades. The Telepal program was developed to provide individualized palliative care, aiming to improve health-related quality of life (HRQoL) and enhance access to health care professionals. OBJECTIVE: This study examined whether the Telepal program influenced HRQoL, symptom burden, perceived health, and patients' sense of security among patients receiving specialized palliative care (SPC). We hypothesized that Telepal would improve HRQoL and sense of security compared with standard SPC. METHOD: In this randomized controlled trial conducted in Denmark, 182 patients referred to SPC were followed for up to 26 weeks. The control group (CG) received routine SPC, while the intervention group (TPG) received routine SPC plus TPC. HRQoL and symptom burden were assessed weekly using the European Organization for Research and Treatment of Cancer Quality of life Questionnaire-Core 15-Palliative Care and at weeks 1 and 4 using the EuroQol Five-Dimension Five-Level Questionnaire, including the Visual Analog Scale for perceived health. Sense of security was assessed twice weekly using a Likert scale. RESULTS: HRQoL, symptom burden, and sense of security worsened over time in both groups, with no significant group differences. The TPG reported consistently higher pain, while perceived health declined in the CG but remained stable in the TPG. CONCLUSION: Telepal did not prevent declines in HRQoL or sense of security; however, perceived health remained more stable in the TPG. Telepal may serve as a complementary component of palliative care, particularly for patients facing barriers to in-person visits.