The following is a summary of “Video and In-Person Palliative Care Delivery Challenges before and during the COVID-19 Pandemic” published in the December 2022 issue of Pain and Symptom Management by Chua et al.


During the coronavirus-19 (COVID-19) epidemic, PC doctors had a lot of difficulties providing outpatient care. Before and during the COVID-19 epidemic in the U.S., researchers discussed patterns concerning the difficulties with in-person and video visit PC delivery.

In a multisite randomized controlled study at 20 academic cancer centers, they examined secondary data on patient characteristics and PC clinician questionnaires. Patients (N = 653) with a recent diagnosis of advanced lung cancer were randomized to either early in-person or telemedicine PC and received at least monthly PC doctor visits. After each visit, PC clinicians filled out surveys describing the difficulties in providing PC care. 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 were the three categories they divided patients into based on the dates of their PC visits in relation the start of the COVID-19 pandemic in the U.S. (all visits after March 1, 2020). To analyze relationships, they used the Kruskal-Wallis, Fisher’s exact, and Pearson’s chi-squared tests.

They looked at 2,329 surveys for video visits, whereas for in-person visits, we looked at 2,176 surveys. The pre/post-COVID-19 subgroup (17.2% [307/1784]), pre/post-COVID-19 subgroup (25.8% [46/178]), and post-COVID-19 subgroup (11.4% [42/367]) (P = 0.0001) were the subgroups with the highest technical issues for video visits, respectively. When it comes to in-person visits, the post-COVID-19 grouping experienced issues with absent patients’ family members the most (6.2% [16/259]), followed by the pre/post-COVID-19 cohort (3.6% [50/1374]), and the pre-COVID-19 subgroup (2.2% [12/543]) (P = 0.02).

Technical issues with PC video visits improved throughout the pandemic, while issues with in-person visits involving missing patients’ relatives worsened.

Reference: jpsmjournal.com/article/S0885-3924(22)00858-2/fulltext