Is virtual early palliative care an option for advanced cancer?

Guidelines recommend early integration of palliative care for patients with advanced cancer, given evidence for improved quality of life (QOL). However, most patients do not receive early palliative care due to limited access and resources. To assess whether early palliative delivered via video could be an option to overcome these barriers, researchers conducted a multicenter trial in patients with advanced non-small-cell lung cancer (NSCLC) and their caregivers. Between 2018 and 2023, 1,250 patients within 12 weeks of diagnosis were randomly assigned to meet with a palliative care clinician every 4 weeks through the course of the disease, either via video or in the outpatient clinic.

The primary outcome of the self-reported QOL in week 24 was equivalent in the virtual and in-person groups. Topics discussed at palliative care visits were similar in the two groups. The groups did not differ in depression and anxiety symptoms or perceptions of the goal of treatment or curability of their cancer. However, caregivers attended more in-person visits than video visits.

Patients with advanced cancers carry a significant burden of in-person visits for cancer-directed therapy. This study demonstrates that virtual visits can be a helpful option to support palliative care needs. Although more caregivers participated in in-person visits than virtual visits, the virtual model may help extend palliative care resources to better serve more patients with advanced cancer.