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：

---

姑息治疗中的远程医疗正在描述，但未进行评估：系统的审查。

背景技术远程医疗正在增长，并且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年英国的一项评论报告说，姑息治疗中对远程医疗的认识不断提高，但缺乏支持其使用的循证研究。这篇评论的主要目的是描述英国远程医疗在姑息治疗中的当前使用，并根据数字服务标准评估远程医疗的举措。第二个目的是探讨远程医疗是否会导致减少急诊服务。方法以主题综合的方式系统回顾文献。筛选了记录，并由两名审阅者提取了数据。使用预定义的术语搜索了EMBASE，MEDLINE，CINAHL，Psychinfo和Cochrane对照试验的中央寄存器。手工搜索会议文献，还进行了论文数据库和引文跟踪。该系统评价的协议已在PROSPERO注册，可以在http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42017080038中找到。结果该搜索确定了3807个标题，并纳入了30项研究。远程医疗被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计划数量有所增加。尽管种类繁多，但许多研究规模较小，具有描述性，并且几乎没有提供评估服务的证据。十篇论文足够详细，可以根据数字服务标准进行评估，其中只有一篇在某种程度上满足了所有标准。七项研究提到了急救服务。结论尽管远程医疗服务不断增长，但仍缺乏评估和强有力的研究设计，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。没有足够的证据来欣赏远程医疗对获得急诊服务的任何好处。需要进一步的工作来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的设计。