Specialized Palliative Telemedicine for Patients with Advanced Cancer

The Effect of Specialized Palliative Telemedicine for Patients with Advanced Cancer At Home

Specialized palliative care (SPC) plays an important role in providing patient-centered care and support to informal caregiver, besides establishing/intensifying/coordinating collaboration with primary and secondary health care sectors (hospital nurse/district nurse and general practitioner/oncologist) to improve care and support for patients and burdened informal caregiver. This study proposes to develop a SPC intervention enriched with a dyadic psychological intervention for patients with advanced cancer and their informal caregiver delivered by telemedicine at home (TeleSPC). It is our hypothesis that the intervention can enhance patient-centered care at home, support their informal caregiver, and improve relations/integration between the SPC teams, oncologic teams, the general practitioners and district nurses.

This is a pilot randomized controlled trial in an open-label fashion, which proposes to develop a SPC intervention enriched with a dyadic psychological intervention (needs-based therapeutic framework based on existential-phenomenological therapy) for patients with advanced cancer and their informal caregiver delivered by telemedicine (video consultation) at home. The primary aim is to investigate the intervention effects on the patients' health-related quality of life (HRQoL). The secondary aims will be to analyze the intervention effects on number of hospitalizations, days spent at home, hospital admissions, survival, dyadic coping between patients and informal caregiver, staff satisfaction with the intervention and caregiver burden in patients' informal caregiver.

Patient inclusion criteria:

• adults (at least 18 years old)
• solid organ cancer
• no longer receives curativ treatment
• provide written informed consent
• are able to speak and understand Danish Language
• are cognitively able to participate in the study
• have at least one symptom or problem with score ≥ 3 at the EORTC QLQ-C30

Patient exclusion criteria:

• primary brain cancer or central nervous system metastases
• a prognosis of less than six months
• incapable of cooperating in the trial
• already receive SPC

Informal caregiver inclusion criteria:

• adults (at least 18 years old)
• indicated by the patient as the closest informal caregiver
• able to speak and understand danish langues
• provide written informed consent

Informal caregiver exclusion criteria:

- refuse to participate in the study