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The assessment of telemedicine to support outpatient palliative care in advanced cancer

Published online by Cambridge University Press:  27 August 2014

Lilian Hennemann-Krause ,
Agnaldo José Lopes ,
Janete Alves Araújo ,
Elisabeth Martins Petersen  and
Rodolfo Acatauassú Nunes
Lilian Hennemann-Krause
Affiliation:
Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Agnaldo José Lopes*
Affiliation:
Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Janete Alves Araújo
Affiliation:
Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Elisabeth Martins Petersen
Affiliation:
Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
Rodolfo Acatauassú Nunes
Affiliation:
Postgraduate Programme in Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil Pedro Ernesto University Hospital, State University of Rio de Janeiro, Rio de Janeiro, Brazil
*
Address correspondence and reprint requests to: Agnaldo José Lopes, Rua Araguaia, 1266, Bloco 1/405, Freguesia, Jacarepaguá, CEP 22745-271, Rio de Janeiro, RJ, Brazil. E-mail: agnaldolopes.uerj@gmail.com.br
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Abstract

Objective:

We aimed to examine telemedicine as a form of home and additional support for traditional outpatient care as a way to remotely monitor and manage the symptoms of patients with advanced cancer.

Method:

In total, 12 patients were monitored through monthly consultations with a multidisciplinary healthcare team and weekly web conferences. To evaluate and treat pain and other symptoms, the Edmonton Symptom Assessment System (ESAS) was applied during all remote or in-person interviews.

Results:

During monitoring, the team contacted the patients on 305 occasions: there were 89 consultations at the hospital, 19 in-person assistances to the family (without the patient), 77 web conferences, 38 telephone calls, 80 emails, and 2 home visits. The mean monitoring time until death was 195 ± 175.1 days. Eight patients who completed the ESAS in all interviews had lower mean distress symptom scores according to web conferences than in person.

Significance of results:

Telemedicine allowed greater access to the healthcare system, reduced the need to employ emergency services, improved assessment/control of symptoms, and provided greater orientation and confidence in the care given by family members through early and proactive interventions. Web conferencing proved to be a good adjuvant to home monitoring of symptoms, complementing in-person assistance.

Keywords

Palliative careTelemedicineCancerSymptoms assessmentPain management
Type
Original Articles
Information
Palliative & Supportive Care , Volume 13 , Issue 4 , August 2015 , pp. 1025 - 1030
Copyright
Copyright © Cambridge University Press 2014 

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