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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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References

REFERENCES

Alberta Health Services (2010). Covenant Health Regional Palliative Care Program: Guidelines for using the Edmonton Symptom Assessment System (ESAS). Available at http://www.palliative.orgPCClinicalInfoAssessmentToolsESAS.pdf.Google Scholar
Balas, E.A., Jaffrey, F., Kuperman, G.J., et al. (1997). Electronic communication with patients: Evaluation of distance medicine technology. The Journal of the American Medical Association, 278(2), 152–159.Google Scholar
Bradford, N., Young, J., Armfield, N.R., et al. (2012). A pilot study of the effectiveness of home teleconsultations in paediatric palliative care. Journal of Telemedicine and Telecare, 18(8), 438–442.Google Scholar
Bradford, N., Armfield, N.R., Young, J., et al. (2013). The case for home based telehealth in pediatric palliative care: A systematic review. BMC Palliative Care, 12, 4.CrossRefGoogle ScholarPubMed
Bruera, E., Kuehn, N., Miller, M.J., et al. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method for the assessment of palliative care patients. Journal of Palliative Care, 7(2), 6–9.Google Scholar
Derek, D., Hanks, G., Nathan, I.C., et al. (2004). Oxford textbook of palliative medicine, 3rd ed. Oxford: Oxford University Press.Google Scholar
Donnem, T., Ervik, B., Magnussen, K., et al. (2012). Bridging the distance: A prospective tele-oncology study in northern Norway. Supportive Care in Cancer, 20(2), 2097–2103.CrossRefGoogle ScholarPubMed
Grossman, S.A., Sheidler, V.R., Swedeen, K., et al. (1991). Correlation of patient and caregiver ratings of cancer pain. Journal of Pain and Symptom Management, 6(2), 53–57.Google Scholar
Hebert, M.A., Paquin, M.J., Whitten, L., et al. (2007). Analysis of the suitability of “video-visits” for palliative home care: Implications for practice. Journal of Telemedicine and Telecare, 13(2), 74–78.CrossRefGoogle ScholarPubMed
Ingham, J., Seidman, A., Yao, T.J., et al. (1996). An exploratory study of frequent pain measurement in a cancer clinical trial. Quality of Life Research, 5(5), 503–507.CrossRefGoogle Scholar
International Agency for Research on Cancer (2008). Cancer incidence, mortality, prevalence and disability-adjusted life years (DALYs) Worldwide GLOBOCAN 2008. Available at http://globocan.iarc.fr/Pages/DataSource_and_methods.aspx.Google Scholar
Johnston, B., Kidd, L., Wengstrom, Y., et al. (2012). An evaluation of the use of Telehealth within palliative care settings across Scotland. Palliative Medicine, 26(2), 152–161.CrossRefGoogle ScholarPubMed
Koczwara, B., Francis, K., Marine, F., et al. (2010). Reaching further with online education? The development of an effective online program in palliative oncology. Journal of Cancer Education, 25(3), 317–323.Google Scholar
Krupinski, E., Nypaver, M., Poropatich, R., et al. (2002). Telemedicine/telehealth: An international perspective. Clinical applications in telemedicine/telehealth. Telemedicine Journal and e-Health, 8(1), 13–34.Google Scholar
Lima, C.M.A.O., Monteiro, A.M.V., Ribeiro, E.B., et al. (2007). Videoconferences: Systematization and experiments in telemedicine. Radiologia Brasileira, 40(5), 341–344.Google Scholar
Mercadante, S., Casuccio, A. & Fulfaro, F. (2000). The course of symptom frequency and intensity in advanced cancer patients followed at home. Journal of Pain and Symptom Management, 20(2), 104–112.CrossRefGoogle ScholarPubMed
National Cancer Institute Brazil (2014). Estimated 2012: Incidence of cancer in Brazil. Available at http://www.inca.gov.br/estimativa/2012/index.asp?ID=5.Google Scholar
Neto, I.G. (2006). Modelos de controlo de sintomas: Manual de cuidados paliativos. Lisboa: Núcleo de Cuidados Paliativos, Centro de Bioética, Faculdade de Medicina de Lisboa.Google Scholar
Paré, G., Sicotte, C., Chekli, M., et al. (2009). A pre–post evaluation of a telehomecare program in oncology and palliative care. Telemedicine Journal and e-Health, 15(2), 154–159.Google Scholar
Rich, B.A. (2001). Physicians' legal duty to relieve suffering. The Western Journal of Medicine, 175(3), 151–152.CrossRefGoogle ScholarPubMed
Ryu, S. (2012). Telemedicine: Opportunities and developments in member states. Report on the Second Global Survey on eHealth, 2009 (Global Observatory for eHealth Series, Vol. 2). Healthcare Informatics Research, 18(2), 153–155.Google Scholar
Stern, A., Valaitis, R., Weir, R., et al. (2012). Use of home telehealth in palliative cancer care: A case study. Journal of Telemedicine and Telecare, 18(5), 297–300.CrossRefGoogle ScholarPubMed
Temel, J.S., Greer, J.A., Muzikansky, A., et al. (2010). Early palliative care for patients with metastatic non-small-cell lung cancer. The New England Journal of Medicine, 363(8), 733–742.Google Scholar
Watanabe, S.M., Fairchild, A., Pituskin, E., et al. (2013). Improving access to specialist multidisciplinary palliative care consultation for rural cancer patients by videoconferencing: Report of a pilot project. Supportive Care in Cancer, 21(4), 1201–1207.Google Scholar
World Health Organization (2013). Cancer: Fact sheet number 297. Available at http://www.who.int/mediacentre/factsheets/fs297/en/index.html.Google Scholar