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* Patients will meet with the PC clinician in person within four weeks of enrollment
* Subsequent visits with the PC clinician will be conducted with the patients in their home or other location using video at least every four weeks
* Patients may be scheduled to meet with the PC clinician in the clinic if requested by the patient or a clinician

* Patients will be scheduled for their first In-person PC visit within four weeks of enrollment and then at least every four weeks thereafter until the patient is no longer coming into the clinic
* PC visits will be scheduled on the same day as an oncology visit if possible

Teleconference meeting with the palliative care team. Palliative care is a medical specialty focused on lessening (or "palliating") patients' symptoms and helping patients and their families cope with a serious illness

Telehealth

In person meeting with the palliative care team. Palliative care is a medical specialty focused on lessening (or "palliating") patients' symptoms and helping patients and their families cope with a serious illness

In-person PC

Jennifer Temel, MD

This research study is evaluating ways to provide palliative care to patients who have recently been diagnosed with lung cancer and their families.

Patients with serious cancers, like advanced lung cancer, often experience physical symptoms, such as pain or shortness of breath. In addition, both patients and their loved ones (family and friends) often feel worried or sad about the cancer diagnosis.

Research has shown that early involvement of a team of clinicians that specialize in lessening (or "palliating") many of these distressing physical and emotional symptoms and in helping patients and their families cope with a serious illness improves patients' and their loved ones' experience with their cancer. This team is called "palliative care," and consists of physicians and advanced practice nurses (or "nurse practitioners") who work closely and collaboratively with the oncology team to care for the participant and the participant's loved ones. Research shows that when the palliative care team works closely with the oncology team to care for patients with advanced cancer, they have better symptom control, quality of life, and mood, and their loved ones feel less distressed. the investigators call this model of care, "early integrated palliative care."

While the investigators know that having palliative care clinicians work closely with the oncology team is helpful for patients and their loved ones, many patients do not have access to these specialists because hospitals and cancer clinics lack enough staff and because some patients and family members live in distant regions that make attending clinic visits difficult and expensive. One way to overcome these barriers is to have patients meet with palliative care clinicians using secure video-conferencing technology.

The purpose of this study is to determine if meeting with a palliative care clinician through video-conferencing is just as beneficial for patients and their families as meeting with a palliative care clinician in person. Specifically, this study will compare these two different strategies for meeting with the palliative care clinician. The first strategy is to schedule the participant to meet with the palliative care clinician regularly each month in person at the clinic. The investigators call this strategy "In-person palliative care."

The second strategy is to schedule the participant to meet with the palliative care clinician regularly each month using secure video-conferencing, such as through a smart phone or tablet computer. If the participant do not have this form of technology, the investigators will provide it for the participant. The investigators call this strategy "telehealth palliative care." The primary goals of this study are to learn if telehealth palliative care is just as effective as in-person palliative care for improving quality of life, mood symptoms, and satisfaction with care for patients with advanced lung cancer and their families.

Early Integrated Telehealth Versus In-Person Palliative Care for Patients With Lung Cancer

Comparative Effectiveness of Early Integrated Telehealth Versus In-Person Palliative Care for Patients With Advanced Lung Cancer

To compare coping strategies in patients assigned to telehealth versus in-person PC as measured by the Brief Cope

To compare prognostic understanding in patients assigned to telehealth versus in-person PC as measured by the PTPQ

To compare prognostic understanding in caregivers of patients assigned to telehealth versus in-person PC as measured by the PTPQ

To compare the effect of telehealth versus in-person PC on caregivers' QOL as measured by the Caregiver Oncology QOL Questionnaire

To compare the effect of telehealth versus in-person PC on caregivers' mood as measured by the HADS

To compare the effect of teleheatlh versus in-person PC on patients' mood as measured by the HADS

To compare the effect of telehealth versus in-person PC on patients' depression as measured by the PHQ-9

To compare the effect of telehealth versus in-person PC on emergency department visits, hospital admissions, chemotherapy administration at the end of life, and hospice service use

To compare the effect of telehealth versus in-person PC on caregiver perceptions of quality of patient death

To compare the effect of Telehealth versus in-person PC on QOL as measured by the FACL-L

To determine whether telehealth PC is equivalent to in-person PC for improving patients' quality of life as measured by the FACT-L

To determine whether telehealth PC is equivalent to in-person PC with respect to patient-clinician communication about EOL care preferences as measured by patient self-report of communication about their wishes if they were dying

To determine whether telehealth PC is equivalent to in-person PC with respect to length of stay in hospice per medical record review

To assess the superiority of telehealth versus in-person PC on caregiver participation in PC visits as per PC clinician documentation

To assess the superiority of telehealth versus in-person PC on patient satisfaction as measured by the Satisfaction and Care Delivery Questionnaire

To assess the superiority of telehealth versus in-person PC on caregiver satisfaction as measured by the Satisfaction and Care Delivery Questionnaire

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Early Integrated Telehealth Versus In-Person Palliative Care for Patients With Lung Cancer	NCT03375489	Lung Cancer	Telehealth In-person PC	18 Years -	Massachusetts General Hospital
Early Integrated Telehealth Versus In-Person Palliative Care for Patients With Lung Cancer	NCT03375489	Lung Cancer	Telehealth In-person PC	18 Years -	Massachusetts General Hospital

Spots Global Cancer Trial Database for lung cancer palliative care