Effectiveness of eHealth interventions and information needs in palliative care: a systematic literature review

Daniel Capurro, Matthias Ganzinger, Jose Perez-Lu, Petra Knaup, Daniel Capurro, Matthias Ganzinger, Jose Perez-Lu, Petra Knaup

Abstract

Background: One of the key components in palliative care is communication. eHealth technologies can be an effective way to support communications among participants in the process of palliative care. However, it is unclear to what extent information technology has been established in this field.

Objective: Our goal was to systematically identify studies and analyze the effectiveness of eHealth interventions in palliative care and the information needs of people involved in the palliative care process.

Methods: We conducted a systematic literature search using PubMed, Embase, and LILACS according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We collected and analyzed quantitative and qualitative data regarding effectiveness of eHealth interventions and users' information needs in palliative care.

Results: Our search returned a total of 240 articles, 17 of which met our inclusion criteria. We found no randomized controlled trial studying the effects of eHealth interventions in palliative care. Studies tended to be observational, non-controlled studies, and a few quasi-experimental studies. Overall there was great heterogeneity in the types of interventions and outcome assessments; some studies reported some improvement on quality of care, documentation effort, cost, and communications. The most frequently reported information need concerned pain management.

Conclusions: There is limited evidence around the effectiveness of eHealth interventions for palliative care patients, caregivers, and health care professionals. Focused research on information needs and high-quality clinical trials to assess their effectiveness are needed.

Keywords: eHealth; palliative Care; systematic review.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
PRISMA flowchart of the systematic review.
Figure 2
Figure 2
Palliative care roles covered in 11 studies included for information needs.

References

    1. Sepúlveda C, Marlin A, Yoshida T, Ullrich A. Palliative Care: the World Health Organization's global perspective. J Pain Symptom Manage. 2002 Aug;24(2):91–6.
    1. Bosch X. Two billion people older than 60 years by 2050, warns UN Secretary General. The Lancet. 2002 Apr;359(9314):1321. doi: 10.1016/S0140-6736(02)08330-7.
    1. Eysenbach G. What is e-health? J Med Internet Res. 2001;3(2):E20. doi: 10.2196/jmir.3.2.e20.
    1. Clarke G, Eubanks D, Reid E, Kelleher C, O'Connor E, DeBar LL, Lynch F, Nunley S, Gullion C. Overcoming Depression on the Internet (ODIN) (2): a randomized trial of a self-help depression skills program with reminders. J Med Internet Res. 2005;7(2):e16. doi: 10.2196/jmir.7.2.e16.
    1. Axén I, Bodin L, Bergström G, Halasz L, Lange F, Lövgren PW, Rosenbaum A, Leboeuf-Yde C, Jensen I. The use of weekly text messaging over 6 months was a feasible method for monitoring the clinical course of low back pain in patients seeking chiropractic care. J Clin Epidemiol. 2012 Apr;65(4):454–61. doi: 10.1016/j.jclinepi.2011.07.012.
    1. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009 Jul 21;6(7):e1000097. doi: 10.1371/journal.pmed.1000097.
    1. Willis L, Demiris G, Oliver DP. Internet use by hospice families and providers: a review. J Med Syst. 2007 Apr;31(2):97–101.
    1. Kidd L, Cayless S, Johnston B, Wengstrom Y. Telehealth in palliative care in the UK: a review of the evidence. J Telemed Telecare. 2010;16(7):394–402. doi: 10.1258/jtt.2010.091108.
    1. Grant L, Brown J, Leng M, Bettega N, Murray SA. Palliative care making a difference in rural Uganda, Kenya and Malawi: three rapid evaluation field studies. BMC Palliat Care. 2011;10:8. doi: 10.1186/1472-684X-10-8.
    1. Kallen MA, Yang D, Haas N. A technical solution to improving palliative and hospice care. Support Care Cancer. 2012 Jan;20(1):167–74. doi: 10.1007/s00520-011-1086-z.
    1. Koczwara B, Francis K, Marine F, Goldstein D, Underhill C, Olver I. Reaching further with online education? The development of an effective online program in palliative oncology. J Cancer Educ. 2010 Sep;25(3):317–23. doi: 10.1007/s13187-009-0037-6.
    1. Lind L, Karlsson D. A system for symptom assessment in advanced palliative home healthcare using digital pens. Med Inform Internet Med. 2004;29(3-4):199–210.
    1. Lind L. Evaluation of the use of digital pens for pain assessment in palliative home healthcare. Stud Health Technol Inform. 2008;136:101–6.
    1. Linklater G, Lawton S, Macaulay L, Carroll D. Palliative patients with pain: Why the family physician phones a specialist advice line. International Journal on Disability and Human Development. 2009;8(1):21–24. doi: 10.1515/IJDHD.2009.8.1.21.
    1. Maudlin J, Keene J, Kobb R. A road map for the last journey: home telehealth for holistic end-of-life care. Am J Hosp Palliat Care. 2006;23(5):399–403. doi: 10.1177/1049909106290807.
    1. McCall K, Keen J, Farrer K, Maguire R, McCann L, Johnston B, McGill M, Sage M, Kearney N. Perceptions of the use of a remote monitoring system in patients receiving palliative care at home. Int J Palliat Nurs. 2008 Sep;14(9):426–31.
    1. van Heest FB, Finlay IG, Kramer JJ, Otter R, Meyboom-de Jong B. Telephone consultations on palliative sedation therapy and euthanasia in general practice in The Netherlands in 2003: a report from inside. Fam Pract. 2009 Dec;26(6):481–7. doi: 10.1093/fampra/cmp069.
    1. Paré G, Sicotte C, Chekli M, Jaana M, De Blois C, Bouchard M. A pre-post evaluation of a telehomecare program in oncology and palliative care. Telemed J E Health. 2009 Mar;15(2):154–9. doi: 10.1089/tmj.2008.0091.
    1. Phillips JL, Davidson PM, Newton PJ, Digiacomo M. Supporting patients and their caregivers after-hours at the end of life: the role of telephone support. J Pain Symptom Manage. 2008 Jul;36(1):11–21. doi: 10.1016/j.jpainsymman.2007.08.017.
    1. Ridley JZ, Gallagher R. Palliative care telephone consultation: who calls and what do they need to know? J Palliat Med. 2008 Sep;11(7):1009–14. doi: 10.1089/jpm.2008.0002.
    1. Roberts D, Tayler C, MacCormack D, Barwich D. Telenursing in hospice palliative care. Can Nurse. 2007 May;103(5):24–7.
    1. Teunissen SC, Verhagen EH, Brink M, van der Linden BA, Voest EE, de Graeff A. Telephone consultation in palliative care for cancer patients: 5 years of experience in The Netherlands. Support Care Cancer. 2007 Jun;15(6):577–82. doi: 10.1007/s00520-006-0202-y.
    1. Walker J, Koberle D, Strasser F. E-MOSAIC: Electronic monitoring of symptoms and syndromes associated with cancer in daily outpatient care for advanced cancer patients. Journal on Information Technology in Healthcare. 2006;4(6):393–400.
    1. Wilkes L, Mohan S, White K, Smith H. Evaluation of an after hours telephone support service for rural palliative care patients and their families: A pilot study. Aust J Rural Health. 2004 Jun;12(3):95–8. doi: 10.1111/j.1440-1854.2004.00568.x.
    1. Coleman J, Olsen SJ, Sauter PK, Baker D, Hodgin MB, Stanfield C, Emerling A, Hruban RH, Nolan MT. The effect of a Frequently Asked Questions module on a pancreatic cancer Web site patient/family chat room. Cancer Nurs. 2005;28(6):460–8.
    1. The World Bank Country and Lending Groups. 2013. [2013-07-01]. .
    1. Lind L, Karlsson D, Fridlund B. Digital pens and pain diaries in palliative home health care: professional caregivers' experiences. Med Inform Internet Med. 2007 Dec;32(4):287–96. doi: 10.1080/14639230701785381.
    1. Tate DF, Finkelstein EA, Khavjou O, Gustafson A. Cost effectiveness of internet interventions: review and recommendations. Ann Behav Med. 2009 Aug;38(1):40–5. doi: 10.1007/s12160-009-9131-6.

Source: PubMed

Sponsorzy i współpracownicy

Warunki medyczne

Interwencje lekowe

3
Subskrybuj