Early palliative care (EPC) delivered via telehealth provides equivalent quality of life (QOL) benefits to in-person visits for patients recently diagnosed with advanced non-small cell lung cancer (NSCLC), according to a groundbreaking study presented at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting. This research, known as the REACH PC trial, offers hope for expanding access to crucial supportive care for this vulnerable population.
This study addresses a critical unmet need for patients with metastatic lung cancer. While advancements in cancer treatment continue, many individuals still experience significant physical and psychological symptoms that impact their QOL. National guidelines recommend integrating palliative care from the time of advanced cancer diagnosis to address these issues. However, access to specialized palliative care clinicians is often limited, creating a barrier to receiving this beneficial care.
Telehealth, particularly through video visits, has emerged as a potential solution to bridge this gap. Its adoption has accelerated significantly since the onset of the COVID-19 pandemic, offering a convenient and accessible alternative to traditional in-person appointments. This approach has also shown promise in reducing healthcare costs for cancer patients. The REACH PC trial aimed to determine if telehealth could deliver the same level of QOL improvement as in-person palliative care.
Telehealth palliative care offers convenience and accessibility for patients with advanced lung cancer.
The REACH PC trial, conducted across 22 US cancer centers, enrolled 1250 patients with advanced NSCLC. Participants were randomly assigned to receive EPC either via telehealth or in-person visits every four weeks. QOL, mood symptoms, coping mechanisms, and perceptions of prognosis were assessed at baseline, 12 weeks, and 24 weeks.
Key Findings of the REACH PC Trial
The study revealed that at 24 weeks, QOL scores were statistically equivalent between the telehealth and in-person EPC groups. This crucial finding confirms that telehealth can effectively deliver palliative care without compromising its benefits.
While caregiver participation rates were lower in the telehealth group, there were no significant differences between the two groups in terms of depression, anxiety, coping skills, or perceptions of treatment goals. Both groups also reported similar levels of satisfaction with the care they received. The lower caregiver participation in telehealth visits may be attributed to the need for assistance with transportation for in-person appointments.
Implications for Cancer Care and Future Research
The REACH PC trial provides compelling evidence to support continued access to telehealth services for advanced NSCLC patients. This finding is particularly relevant for vulnerable populations facing challenges accessing in-person care. These results can inform policy decisions regarding telehealth coverage and integration into standard oncology practice.
Further research is needed to determine the optimal scenarios for telehealth use in palliative care, considering factors like patient preferences, disease characteristics, and sociodemographic variables. This research should also address the role of caregivers in telehealth interventions and explore strategies to enhance their involvement.
Conclusion: Expanding Access to Essential Care
The REACH PC trial demonstrates the potential of telehealth to democratize access to essential palliative care for individuals with advanced lung cancer. By leveraging technology, we can overcome geographical barriers and resource limitations, ensuring that more patients receive the supportive care they need to improve their QOL throughout their cancer journey. For personalized treatment plans and access to palliative care services, consult with a healthcare professional.
REFERENCE
Greer J, Gralow J, Aggarwal C. On-Site Briefing on Plenary Abstracts. 2024 American Society of Clinical Oncology Annual Meeting; May 31 – June 4, 2024; Chicago, Illinois.
