Efficiency of Using Telemedicine Services in the Palliative Care Group at Warin Chamrap Hospital: A Randomized Controlled Trial

Abstract

Objective: This study aimed to evaluate the efficacy of telemedicine services in palliative care at Warin Chamrap Hospital.

Methods: A randomized controlled trial (RCT) was conducted among palliative care patients at the hospital between 2023 and 2024. Patients were randomly assigned to either the intervention group receiving telemedicine-based palliative care or the control group receiving standard care, with 28 participants in each group.

Results: Upon comparing data between week 1 and week 4, the Palliative Performance Scale (PPS) in the intervention group declined from 56.09±6.56 to 49.56±14.29 (p = 0.022), whereas the control group showed a non-significant reduction from 52.22±7.51 to 50.74±9.97 (p = 0.515). In terms of pain severity, assessed using the Edmonton Symptom Assessment System (ESAS), the intervention group demonstrated a significant reduction from 5.09±2.63 to 1.52±1.56 (p < 0.001), while the control group showed a similar trend, decreasing from 6.52±2.62 to 2.41±1.99 (p < 0.001).However, there were no statistically significant differences in hospital admission rates (Admit), outpatient clinic visits (OPD), and emergency department visits (ER) between the telepalliative care and control groups (p = 0.585, 0.704, and 0.440, respectively). Family satisfaction scores were slightly higher in the intervention group (40.67±6.14) compared to the control group (38.48±6.76), though the difference was not statistically significant (p = 0.235). These findings suggest that telepalliative care significantly reduces pain intensity (p < 0.001) and may help alleviate caregiving burdens, as evidenced by a trend toward higher family satisfaction in the intervention group.

Conclusion: Further studies are warranted to optimize telemedicine-based palliative care models in alignment with Thailand’s healthcare system and sociocultural context