title: A Systematic Review of Telehealth in Palliative Care: Caregiver Outcomes.
abstract: OBJECTIVE
  Telehealth interventions have proven efficacy in healthcare, but little is known about the results of such interventions in palliative care. We conducted a systematic review to evaluate caregiver outcomes related to palliative telehealth interventions.
  
  
  METHODS
  We searched multiple databases for articles published between January 2003 and January 2015 related to telehealth in palliative care. Two hundred twenty-one articles were considered; nine of these met study inclusion criteria. Data on study design, population, interventions, methods, outcomes, conclusions, and methodological quality were extracted and evaluated by three investigators.
  
  
  RESULTS
  Of the nine studies, five measured caregiver quality of life, three measured caregiver anxiety, and two measured caregiver burden. All the studies measuring caregiver quality of life showed no significant difference after telehealth interventions. The caregiver anxiety score decreased after the intervention in two studies, and one study reported significantly reduced caregiver burden. Although feasibility of or caregiver satisfaction with the telehealth intervention was not the focus of this review, most studies reported such findings. Of the nine studies, the majority were rated as having moderate quality using the Cochrane Collaboration's tool for assessing risk of bias.
  
  
  CONCLUSIONS
  This systematic review suggests there is evidence of overall satisfaction in caregivers who undergo a telehealth intervention, but outcomes reported were often not substantial. Methodological flaws and small sample sizes negatively affected study quality. More rigorous research to test and evaluate such palliative interventions is needed.
authors.affiliation: 1 Kent School of Social Work, University of Louisville , Louisville, Kentucky.
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: 2 School of Medicine, University of Louisville , Louisville, Kentucky.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Head
authors.affiliation: 2 School of Medicine, University of Louisville , Louisville, Kentucky.
authors.forename: Tara J
authors.initials: TJ
authors.lastname: Schapmire
mesh_terms: D001007:Anxiety / Q000523:psychology / Q000628:therapy; D017028:Caregivers / Q000523:psychology*; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D017060:Patient Satisfaction; D011788:Quality of Life; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy; D017216:Telemedicine / Q000379:methods*
keywords: caregiver; hospice care; intervention; palliative care; telehealth