The Use, Effectiveness and Acceptability of Telemedicine Interventions in the Provision of Palliative Care in Rural Populations

Inequalities in the provision of palliative care have been well-documented between urban and rural populations, with rural areas experiencing poorer accessibility to specialist services. With increasing prevalence of chronic conditions, this disparity will only increase, and it is, therefore, essential to find methods which will enhance available resources. Telemedicine has been a proposed solution. The aims of this systematic review were to identify the use of telemedicine interventions within palliative care in rural settings, assess their effectiveness, and identify provider and user acceptability, to then inform and guide service development in Scotland. An electronic search of MEDLINE, EMBASE, PsychINFO and CINAHL was performed. A total of 3112 papers were identified and 16 papers were included in this review. A range of telemedicine applications have been found to be effective and acceptable and there appears to be a perceived need for telemedicine across palliative rural communities in Scotland. However, there is lack of evidence besides users’ subjective perceptions. Future research needs to move from qualitative, descriptive studies to clinical trials in order to assess the effectiveness of these interventions. To optimise their use, the needs of the targeted populations must be assessed and each specific intervention tailored accordingly.