Early integrated palliative care (EIPC) significantly improves clinical outcomes for patients with advanced cancer. Telehealth may be a useful tool to deliver EIPC sustainably and equitably. Palliative care clinicians completed a survey regarding their perceptions of the barriers, facilitators, and benefits of using telehealth video visits for delivering EIPC for patients with advanced lung cancer. Forty-eight clinicians across 22 cancer centers completed the survey between May and July 2022. Most (91.7%) agreed that telehealth increases access to EIPC and simplifies the process for patients to receive EIPC (79.2%). Clinicians noted that the elderly, those in rural areas, and those with less-resourced backgrounds have greater difficulty using telehealth. Perceived barriers were largely patient-based factors, including technological literacy, internet and device availability, and patient preferences. Clinicians agreed that several organizational factors facilitated telehealth EIPC delivery, including technological infrastructure (85.4%), training (83.3%), and support from study coordinators (81.3%). Other barriers included systems-based factors, such as insurance reimbursement and out-of-state coverage restrictions. Patient-, organization-, and systems-based factors are all important to providing and improving access to telehealth EIPC services. Further research is needed to investigate the efficacy of telehealth EIPC and how policies and interventions may improve access to and dissemination of this care modality.
早期整合姑息治疗（EIPC）能显著改善晚期癌症患者的临床结局。远程医疗可能成为可持续、公平提供EIPC的有效工具。姑息治疗临床医生完成了一项关于使用远程医疗视频访视为晚期肺癌患者提供EIPC的障碍、促进因素及益处的认知调查。2022年5月至7月期间，来自22个癌症中心的48名临床医生完成了调查。绝大多数（91.7%）受访者认同远程医疗能增加EIPC的可及性，79.2%认为其简化了患者接受EIPC的流程。临床医生指出老年人、农村地区居民及资源匮乏群体在使用远程医疗时面临更大困难。主要障碍源于患者自身因素，包括技术素养、网络与设备可用性及患者偏好。临床医生认为多项组织因素促进了远程医疗EIPC的实施，包括技术基础设施（85.4%）、培训支持（83.3%）和研究协调员协助（81.3%）。其他障碍涉及系统层面因素，如保险报销和跨州覆盖限制。患者、组织和系统三方面因素对提供和改进远程医疗EIPC服务均至关重要。未来需进一步研究远程医疗EIPC的实际效能，以及如何通过政策干预提升该护理模式的可及性与推广度。
肿瘤(癌症)患者之家