The following is a summary of “Quality of Telehealth-Delivered Inpatient Palliative Care During the Early COVID-19 Pandemic,” published in the JANUARY 2023 issue of Pain and Symptom Management by Soliman, et al.
The Palliative Care (PC) service at a big New England hospital switched from in-person to telehealth-delivered PC (TPC) due to rising COVID-19 infection rates. During the early COVID-19 epidemic, researchers compared TPC’s performance with that of in-person PC.
Pre-COVID January 2020–February 2020 (in-person); peak COVID March 2020–June 2020 (majority TPC); and post-peak September 2020–October 2020 (majority in-person), an electronic health record review of PC consultations of patients hospitalized over three periods was conducted. Using descriptive and bivariate statistics, they looked at the connections between these times and the features of PC delivery and quality metrics.
Over 50 patients out of 377 were pre-COVID (TPC = 0%), 271 were pre-COVID (TPC = 79.3%), and 56 were post-peak (TPC <2%) (representative of PC consult: pre- and post-peak = samples; peak-COVID = all consultations). The average age was 69.3 years (standard deviation: 15.5), 68.7% of the population was White, and 22.8% was Black. Age and gender did not vary by time period. PC consults were more prevalent for care objectives during peak-COVID compared to pre-COVID (30.0% vs. 53.9% vs. post=57.1%; P = 0.005) and hospice (4.0% vs. 14.4% vs. 5.4%; P = 0.031). When compared to pre-COVID and post-peak periods, peak rates of evaluation of physical symptoms were lower (98.0% vs. 63.5% vs. 94.6%, P< 0.001), and psychological symptoms were lower (90.0% vs. 33.1% vs. 67.9%, P< 0.001). The evaluation of patients’ social requirements, family responsibilities, or care objectives stayed the same over time.
Despite tremendous pressure during the early COVID-19 epidemic, the PC service delivered high-quality inpatient PC utilizing TPC. To address any possible unmet PC needs, developing and testing methods to encourage thorough symptom management utilizing TPC remains a priority.