BACKGROUND Telehealth is growing and its application in palliative care is seen as a solution to pressures on palliative care services. A 2010 UK review reported growing awareness of telehealth in palliative care but a lack of evidence-based research to support its use. The primary aim of this review was to describe the current use of telehealth in palliative care in the UK and evaluate telehealth initiatives against a digital service standard. The secondary aim was to explore whether telehealth results in a reduction in emergency care access. METHODS Systematic review of the literature with thematic synthesis. Records were screened and data extracted by two reviewers. EMBASE, MEDLINE, CINAHL, Psychinfo and Cochrane central register for controlled trials were searched using pre-defined terms. Hand searching of conference literature, thesis databases and citation tracking was also conducted. The protocol for this systematic review was registered with PROSPERO and can be found at http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017080038. RESULTS The search identified 3807 titles and 30 studies were included in the review. Telehealth was used to support patients and carers, electronic record keeping and professional education. Notably, the number of home telemonitoring initiatives for patients had increased from the 2010 review. Despite this variety, many studies were small scale, descriptive and provided little evidence of evaluation of the service. Ten papers were sufficiently detailed to allow appraisal against the digital service standard and only one of these met all of the criteria to some extent. Seven studies made reference to emergency care access. CONCLUSIONS Although there is growth of telehealth services, there remains a lack of evaluation and robust study design meaning conclusions regarding the clinical application of telehealth in palliative care cannot be drawn. There is insufficient evidence to appreciate any benefit of telehealth on access to emergency care. Future work is needed to evaluate the use of telehealth in palliative care and improve telehealth design in line with digital service standards.

中文翻译：

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姑息治疗中的远程医疗正在被描述但尚未评估：系统评价。


背景技术远程医疗正在发展，其在姑息治疗中的应用被视为缓解姑息治疗服务压力的解决方案。 2010 年英国的一项审查报告称，人们对姑息治疗中的远程医疗的认识不断增强，但缺乏基于证据的研究来支持其使用。本次审查的主要目的是描述英国姑息治疗中远程医疗的当前使用情况，并根据数字服务标准评估远程医疗举措。第二个目标是探讨远程医疗是否会导致获得紧急护理的机会减少。方法 通过主题综合系统地回顾文献。由两名评审员筛选记录并提取数据。使用预定义术语搜索 EMBASE、MEDLINE、CINAHL、Psychinfo 和 Cochrane 对照试验中央登记册。还进行了会议文献、论文数据库和引文跟踪的手工检索。本系统评价的方案已在 PROSPERO 注册，可在 http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017080038 找到。结果 检索确定了 3807 个标题，综述中纳入了 30 项研究。远程医疗用于支持患者和护理人员、电子记录保存和专业教育。值得注意的是，自 2010 年审查以来，针对患者的家庭远程监护举措的数量有所增加。尽管存在这种多样性，但许多研究都是小规模的、描述性的，并且几乎没有提供服务评估的证据。十篇论文足够详细，可以根据数字服务标准进行评估，但只有一篇在某种程度上满足所有标准。七项研究提到了紧急护理的可及性。 结论 尽管远程医疗服务有所增长，但仍然缺乏评估和稳健的研究设计，这意味着无法得出有关远程医疗在姑息治疗中的临床应用的结论。没有足够的证据表明远程医疗对获得紧急护理有任何好处。未来的工作需要评估远程医疗在姑息治疗中的使用，并根据数字服务标准改进远程医疗设计。