The use of telemedicine for home-based palliative care for children with serious illness: a scoping review

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 PRISMA-ScR 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 (RE-AIM) 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 RE-AIM 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 in order to guide and facilitate broader dissemination.