Equity in digital palliative care: a scoping review of disparities and facilitators

Digital health technologies offer significant potential to enhance palliative care delivery but concerns persist regarding equitable access across diverse populations. This scoping review maps the existing literature on digital palliative care interventions, identifies barriers and facilitators to equitable access. Following Arksey and O’Malley’s framework, as advanced by the Joanna Briggs Institute (JBI) methodology for scoping reviews and PRISMA-ScR guidelines, a systematic search was conducted across seven databases in July 2026. Studies were eligible if they involved palliative care populations, described digital health interventions and reported on equity-related outcomes. Two reviewers independently screened studies and extracted data for narrative synthesis. Eleven studies published between 2017 and 2025 were included. Most were conducted in high-income countries (United States, n = 5; Australia, n = 2), with single studies from China, Bangladesh, Mexico and Australia-Denmark. No eligible studies were identified from the African continents. Interventions included telemedicine, telephone services, messaging apps and online toolkits. The key barriers to equitable access were digital illiteracy among older adults, language and cultural discordance, limited rural connectivity, financial constraints and systemic design biases. Facilitators included familiar platforms, culturally tailored interventions, hybrid service models, lay navigator support and structural enablers such as insurance coverage. Positive outcomes included improved symptom control and reduced caregiver burden; however, disparities persisted in screening rates and telemedicine utilisation across race, language and insurance status. Digital palliative care interventions hold promise for enhancing access, but their potential to reduce disparities remains unrealised without equity-focused approaches. Critical evidence gaps persist in low- and middle-income countries. Future efforts must prioritise co-design with underserved communities, invest in digital infrastructure alongside non-digital alternatives and integrate equity metrics into implementation frameworks.