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Randomised controlled trial
It is unclear whether specialist palliative care teleconsultation leads to an improvement in patient symptom scores
  1. Doris Howell1,2
  1. 1 Department of Psychosocial Oncology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
  2. 2 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Doris Howell, Department of Psychosocial Oncology, Princess Margaret Hospital Cancer Centre, Toronto, ON M5G 2M9, Canada; doris.howell{at}

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Commentary on: Hoek PD, Schers HJ, Bronkhorst EM, et al. The effect of weekly specialist palliative care teleconsultations in patients with advanced cancer—a randomized clinical trial. BMC Med 2017;15:119.

Implications for practice and research

  • Routine assessment of symptoms during palliative care teleconsultation is essential, but awareness to the potential for attention to symptoms to add to patients’ suffering is needed. 

  • Research in palliative care needs to take into consideration the issues of recruitment/retention, and studies must be planned to ensure adequate power.

  • Clinically meaningful endpoints for symptom measures are needed to measure both within-group and between-group change.


There is a growing body of evidence that earlier integration of palliative care in the trajectory of advanced illness can improve quality of life. This has led to increasing calls for specialist palliative care services that are scalable and can be delivered outside of urban centres.1 …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.