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Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic
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Authors
Chua, Isaac SOlmsted, Molly
Plotke, Rachel
Turk, Yael
Trotter, Chardria
Rinaldi, Simone
Kamdar, Mihir
Jackson, Vicki A
Gallagher-Medeiros, Emily R
El-Jawahri, Areej
Temel, Jennifer S
Greer, Joseph A
UMass Chan Affiliations
T.H. Chan School of MedicineDocument Type
Journal ArticlePublication Date
2022-08-17
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Context: Palliative care (PC) clinicians faced many challenges delivering outpatient care during the coronavirus-19 (COVID-19) pandemic. Objectives: We described trends for in-person and video visit PC delivery challenges before and during the COVID-19 pandemic in the U.S. Methods: We performed a secondary data analysis of patient characteristics and PC clinician surveys from a multisite randomized controlled trial at 20 academic cancer centers. Patients newly diagnosed with advanced lung cancer (N = 653) were randomly assigned to receive either early in-person or telehealth PC and had at least monthly PC clinician visits. PC clinicians completed surveys documenting PC delivery challenges after each encounter. We categorized patients into 3 subgroups according to their PC visit dates relative to the onset of the COVID-19 pandemic in the U.S.-pre-COVID-19 (all visits before March 1, 2020), pre/post-COVID-19 (≥1 visit before and after March 1, 2020), and post-COVID-19 (all visits after March 1, 2020). We performed Pearson's chi-squared, Fisher's exact, and Kruskal-Wallis tests to examine associations. Results: We analyzed 2329 surveys for video visits and 2176 surveys for in-person visits. For video visits, the pre-COVID-19 subgroup (25.8% [46/178]) had the most technical difficulties followed by the pre/post-COVID-19 subgroup (17.2% [307/1784]) and then the post-COVID-19 subgroup (11.4% [42/367]) (P = 0.0001). For in-person visits, challenges related to absent patients' family members occurred most often in the post-COVID-19 subgroup (6.2% [16/259]) followed by the pre/post-COVID-19 subgroup (3.6% [50/1374]) and then the pre-COVID-19 subgroup (2.2% [12/543]) (P = 0.02). Conclusion: Technical difficulties related to PC video visits improved, whereas in-person visit challenges related to absent patients' family members worsened during the pandemic.Source
Chua IS, Olmsted M, Plotke R, Turk Y, Trotter C, Rinaldi S, Kamdar M, Jackson VA, Gallagher-Medeiros ER, El-Jawahri A, Temel JS, Greer JA. Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic. J Pain Symptom Manage. 2022 Aug 17:S0885-3924(22)00858-2. doi: 10.1016/j.jpainsymman.2022.08.005. Epub ahead of print. PMID: 35985551; PMCID: PMC9383956.DOI
10.1016/j.jpainsymman.2022.08.005Permanent Link to this Item
http://hdl.handle.net/20.500.14038/51192PubMed ID
35985551Rights
Copyright © 2022 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.ae974a485f413a2113503eed53cd6c53
10.1016/j.jpainsymman.2022.08.005