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Quality of care metrics contributing to the development, implementation, and evaluation processes of telehealth solutions in home-care settings for paediatric palliative care: protocol for a systematic literature review

Por: Adlung · C. · Niehot · C. · van Capelle · C.

Paediatric palliative care (PPC) aims to improve the quality of life of children with life-limiting and life-threatening conditions. PPC addresses the needs of both the child and family and preferably starts immediately after a palliative diagnosis. It includes effective symptom management, psychosocial, spiritual and emotional support. Receiving PPC is often challenging due to the varied and complex nature of conditions and the difficulties in reaching all children who require palliative care. Telehealth offers a promising solution by enabling virtual access to interdisciplinary teams, facilitating real-time consultations, extending care into the home, educating professionals across regions and fostering consistent, collaborative, patient- and family-centred PPC. As this requires a seamless integration into the daily routines of all relevant stakeholders, telehealth may raise complexity in terms of privacy, data protection and regulatory compliance. Nevertheless, studies indicate that parents and children are open to using telehealth applications.

Since the COVID-19 pandemic, telehealth development in paediatrics showed a rapid and substantial scale-up. Evaluating the quality of these new technical solutions remains important. One of the main outcome measures used in telehealth evaluation studies is quality of care. Currently, the literature has no consensus on which quality of care metrics can be used to assess the development, implementation and evaluation of telehealth solutions in home-care PPC. In addition, a timely update on the fast-growing field of telehealth solutions in PPC is required. Therefore, this study aims to update and examine quality of care metrics in telehealth solutions for PPC, contributing to the conceptual foundation for the development, implementation and evaluation of home-based PPC telehealth services. Findings from our review will contribute to a deeper understanding of how children and families can receive timely and accessible palliative care regardless of their location, ultimately informing future telehealth models and research projects.

Methods and analysis

Our systematic review will evaluate studies that describe telehealth solutions in PPC home-care settings, using the Cochrane handbook, and the reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We will include peer-reviewed articles without language or geographical restrictions. The search will be conducted by an information specialist and data synthesis will be documented via a data extraction table in MS Excel. Along with a Mixed-Method-Appraisal-Tool (MMAT) quality appraisal, data extraction will be managed by Covidence. Two reviewers will screen and extract data independently, with a third reviewer resolving discrepancies. We will present a narrative synthesis, using clear language, defining key terms and following open-access standards to ensure accessibility for non-expert audiences.

Ethics and dissemination

No primary or clinical data will be collected. Therefore, ethical approval is not relevant. Review findings will be shared via peer-reviewed journal publications, conferences, stakeholder meetings and online presentations.

PROSPERO registration number

CRD420251035350.

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