The Use of Telemedicine for Home-Based Palliative Care for Children With Serious Illness: A Scoping Review

Kimberly A Miller; Jennifer Baird; Jessica Lira; Josseline Herrera Eguizabal; Shangnon Fei; Lynn Kysh; Debra Lotstein

doi:10.1016/j.jpainsymman.2020.12.004

The Use of Telemedicine for Home-Based Palliative Care for Children With Serious Illness: A Scoping Review

J Pain Symptom Manage. 2021 Sep;62(3):619-636.e6. doi: 10.1016/j.jpainsymman.2020.12.004. Epub 2020 Dec 19.

Authors

Kimberly A Miller¹, Jennifer Baird², Jessica Lira², Josseline Herrera Eguizabal³, Shangnon Fei⁴, Lynn Kysh², Debra Lotstein⁵

Affiliations

¹ Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA; Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
² Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, California, USA.
³ Department of Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA.
⁴ Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
⁵ Department of Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California, USA; Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA. Electronic address: dlotstein@chla.usc.edu.

PMID: 33348029
DOI: 10.1016/j.jpainsymman.2020.12.004

Abstract

Context: There is potential value to home-based palliative care for children with serious illness delivered via telemedicine (TM HBPC). Evidence to guide optimal design and delivery of TM HBPC is urgently needed.

Objectives: To explore the existing literature to identify research on pediatric TM HBPC.

Methods: Systematic scoping review conducted following preferred reporting items for systematic reviews and meta-analysis for scoping reviews guidelines. PubMed, Embase, Cochrane CENTRAL, CINAHL, Web of Science, PsycINFO, and ERIC were searched (January-April 2020) using keywords and controlled vocabulary. The Reach, Effectiveness, Adoption, Implementation, Maintenance framework was used to identify components in the literature that facilitate or limit dissemination of TM HBPC interventions.

Results: Seventeen articles were included. Most of the literature comprised small descriptive studies, such as case reports, and feasibility trials. Many studies focused on acceptability, and the TM HBPC model was generally acceptable to both clinicians and families. Few studies measured patient access to care, patient, and family centered health or quality of life outcomes. While included studies addressed multiple criteria for each of the Reach, Effectiveness, Adoption, Implementation, Maintenance dimensions, much of the information was qualitative and subjective.

Conclusion: TM HBPC is a promising strategy to increase access to palliative care for children with serious illness. However, the current review found a need for more robust information describing implementation and effectiveness of TM HBPC models, adaptation across care settings, and maintenance over time to guide and facilitate broader dissemination.

Keywords: Pediatrics; home-based palliative care; palliative care; telemedicine.

Publication types

Research Support, Non-U.S. Gov't
Review
Systematic Review

MeSH terms

Child
Home Care Services*
Hospice and Palliative Care Nursing*
Humans
Palliative Care
Quality of Life
Telemedicine*