Virtual visits in outpatient palliative care have surged in recent years, particularly during the pandemic, offering a promising solution for homebound older adults with serious illnesses. The link between virtual visits and palliative care outcomes is largely unknown, especially among marginalized populations such as individuals with preferred languages other than English. No studies have examined the simultaneous differences in palliative care visits by visit modality and patient characteristics among different patient subgroups.
To address this gap, Nouri and colleagues (2025) conducted a multisite study of 2684 outpatient palliative care patients to examine the association between virtual and in-person visit type and screening for psychosocial, spiritual, and goals of care needs and to assess differences by language and race.
The researchers used data from the Palliative Care Quality Network (PCQN) a United States national, multisite collaborative of interdisciplinary palliative care teams that collect standardized patient data. Six PCQN sites, all located in California and Hawai’I, that consistently recorded race/ethnicity and preferred language data were included. All adults (18+ years old) with at least one outpatient palliative care visit at the included sites between January 2017 and March 2021 were included in the study.
Dichotomous outcome measures were: 1) screening for psychosocial needs, 2) screening for spiritual needs, and 3) screening for goals of care needs at patients’ initial outpatient palliative care visit. The primary predictor measure was visit type, defined as either in-person or virtual. Covariates included age, sex (male or female), self-reported race-ethnicity (non-Hispanic White, Hispanic/Latinx, Black/African American, Asian, Other including Native Hawaiian/Pacific Islander, American Indian/Alaska Native, and all other races and/or ethnicities not included in other categories), and preferred language (English, Spanish, Chinese, and Other).
Of 2,684 initial visits, 780 (29%) were conducted virtually. Older adults were more likely to be seen virtually, as were White and English-speaking patients. Patients with a preferred language other than English were significantly less likely to be screened for psychosocial needs, spiritual needs, and goals of care needs. These differences in screening were most notable for Spanish-speaking and Chinese-speaking patients. Patients identifying as Hispanic/Latinx or Black/African American were significantly less likely to be screened for psychosocial needs, spiritual needs, and goals of care needs
The authors identified that there were no differences in rates of screening for psychosocial, spiritual, or goals of care needs in virtual versus in-person visits. However, patients with preferred languages other than English and those identifying as Black had lower odds of screening.
Source: Nouri, S., Pantilat, S. Z., Ritchie, C. S., Lyles, C. R., Shi, Y., O’Riordan, D., … & Sudore, R. L. Quality of Virtual vs. In-Person Outpatient Palliative Care: Disparities by Language and Race. Journal of Pain and Symptom Management.
