There is extensive need for palliative care worldwide, but access to care remains inadequate, especially for non-cancer patients. Video consultations are a promising tool in the provision of home-based palliative care, but an overview of evidence solely on video consultations in palliative care is lacking. To review and synthesize current evidence regarding the use of video consultations in general and specialized palliative care to various patient groups. A systematic integrative review with a narrative synthesis was undertaken in accordance with PRISMA (2009) guidelines. PROSPERO #: CRD42018095383 PubMed, Embase, CINAHL, and PsychINFO were searched for primary research articles published between 2005 and 2018. In addition, reference lists of included articles were hand searched. The search resulted in 813 articles; 39 articles were included in the review, consisting of mixed methods (n = 14), qualitative (n = 10), quantitative (n = 10), and case studies (n = 5). The studies mainly focused on specialized palliative care to adult patients with cancer in high income countries. Through data analysis, six themes addressing advantages/disadvantages and facilitators/barriers were identified: (1) Redesign of care, (2) Communication, (3) User perceptions, (4) Technology, (5) Privacy issues, and (6) Economic implications. Using video technology in palliative care has both advantages and disadvantages. However, evidence beyond the focus on specialized palliative care and patients with cancer is limited. Future research should focus on how and when video consultations might replace in-person specialized palliative care and video consultations in general palliative care, in low and middle income countries; and involve patients with a non-cancer diagnosis.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: The work of specialized palliative care (SPC) teams is often challenged by substantial amounts of time spent driving to and from patients’ homes and long distances between the patients and the hospitals. Objective: Video consultations may be a solution for real-time SPC at home. The purpose of this study was to explore the use of video consultations, experienced by patients and their relatives, as part of SPC at home. Methods: This explorative and qualitative study included palliative care patients in different stages and relatives to use video consultations as a part of their specialized palliative care between October 2016 and March 2017. Data collection took place in the patients´ homes and consisted of participant-observations followed by semi-structured interviews. Inclusion criteria: patients with the need for SPC, > 18 years, who agreed to participate and relatives wanting to participate in the video consultations. Data were analyzed with Giorgi´s descriptive phenomenological methodology. Results: A number of n=11 patients and n=3 relatives were included, and in total n=86 video consultations were conducted. Patients participating varied in time from 1 month to 6 months, and number of video consultations per patient varied from three to 18. The use of video consultations led to a situation where patients, despite life-threatening illnesses and technical difficulties, took an active role. Additionally, relatives were able to join on equal terms which increased active involvement. The patients had different opinions on when to initiate the use of video consultations in SPC, as the initiating stage, but also the final stage of illness was experienced optional. If the video consultations included multiple participants from the SPC team, the use of video consultations could be difficult to complete without interruptions. Conclusions: Video consultations in SPC for home-based patients are feasible and facilitate a strengthened involvement and communication between patients, relatives and SPC team members.