Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trial

Palliative video consultation and symptom distress among rural inpatients-A randomized clinical trial
Critical Care Medicine; by Marie A. Bakitas, Shena Gazaway, Felicia Underwood, Christiana Ekelem, Vantrice T. Heard,  Richard Kennedy, Andres Azuero, Rodney Tucker, Susan McCammon, Joshua M. Hauser, Lucas McElwain, Ronit Elk; 7/25
The triple threat of rural geography, racial inequities, and older age has hindered access to high-quality palliative care for many people in the US. Only 70% of the deep South vs 85% to 94% of the rest of the US has palliative care despite the deep South having the greatest needs due to suboptimal health care access and elevated morbidity and mortality. In this RCT [randomized clinical trial] among Black or African American and White chronically ill hospitalized adults, culturally based specialist palliative care video consultation was not associated with statistically significant reduced symptom distress compared with usual care, but there was a clinically meaningful difference ... between groups. Contrary to our hypotheses, intervention participants’ QOL [quality of life] and resource use (secondary outcomes) also were not improved.
Assistant Editor's note: This study reminds us that palliative care delivered virtually, as opposed to in-person, may not be of benefit to some individuals. It also reminds us that palliative care, in its finest form, usually works best when delivered on an ongoing basis by a known, trusted professional(s).