The research questions are: (1) What are the application forms of telemedicine in HBPC patients? (2) What content elements are included in telemedicine-based interventions? (3) What is the application effectiveness of telemedicine for HBPC patients, and what are the corresponding evaluation indicators?

The search strategy was developed in consultation with a medical librarian. To ensure a comprehensive literature review, search strings were constructed using a combination of Medical Subject Headings (MeSH) and free-text keywords corresponding to three core concepts: (1) telemedicine/telehealth/telecare/remote care, (2) home-based care, and (3) palliative care/hospice care. We referenced keywords from existing reviews on similar topics to enhance sensitivity. Searches were conducted from the inception of each database until November 22, 2025, across the following electronic databases: PubMed, Web of Science, Embase, Cochrane Library, CINAHL, CNKI, Wanfang Database, and the Chinese Biomedical Literature Database (CBM). Manual searching of reference lists from key articles was also performed to identify additional relevant studies. No restrictions were applied regarding language or publication status. Taking PubMed as an example, the search strategy was as follows: [“Telemedicine” (MeSH Terms) OR “Telehealth” (MeSH Terms) OR “Remote Consultation” (MeSH Terms)] OR (“mobile health” (Title/Abstract) OR “mHealth” (Title/Abstract) OR “eHealth” (Title/Abstract) OR “digital health” (Title/Abstract) OR “telecare” (Title/Abstract) OR “remote care” (Title/Abstract) OR “virtual care” (Title/Abstract)] AND {“Home Care Services” (MeSHTerms) OR [“Home” (Title/Abstract) OR “Home-Based” (Title/Abstract) OR “home care” (Title/Abstract)]} AND {“Palliative Care” (MeSH Terms) OR “Hospice Care” (MeSH Terms) OR [“palliative care” (Title/Abstract) OR “hospice care” (Title/Abstract) OR “terminal care” (Title/Abstract) OR “end of life care” (Title/Abstract)]}.

Inclusion criteria: (1) Study participants were HBPC patients; (2) The intervention involved applying various telemedicine technologies to provide services and support for HBPC patients; (3) Study types included randomized controlled trials (RCTs), quasi-experimental studies, mixed-methods studies, etc.

Exclusion criteria: (1) Interventions were not specific or consisted solely of phone calls, text messages, or emails; (2) Non-Chinese or non-English literature; (3) Full text unavailable; (4) Literature types such as study protocols, guidelines, reviews, etc.

All retrieved records were imported into EndNote X9 (Clarivate Analytics) for deduplication. Two independent reviewers (CZ and HND) screened titles and abstracts against the eligibility criteria. Full-text articles of potentially relevant studies were retrieved and independently assessed. Discrepancies at each stage were resolved through discussion or, if necessary, adjudication by a third reviewer (LCX). The study selection process was documented using a PRISMA flow diagram (Figure 1).

A standardized, pilot-tested data charting form was developed in Microsoft Excel. Two reviewers independently extracted data from included studies. The form captured: (1) study characteristics (author, year, country, design); (2) participant characteristics (sample size, patient group); (3) intervention details (telemedicine modality/application platform, development method, core content elements, intervention frequency and duration, comparator); (4) outcome measures and assessment tools; and (5) key findings related to feasibility, effectiveness, and patient/caregiver experience. To move beyond a narrative listing and facilitate comparison across studies, extracted data were synthesized thematically. Findings were grouped by intervention modality, core content, and outcomes to identify patterns and gaps in the evidence base.

An initial search yielded 2,207 records. After multi-layered screening, 18 articles (12, 15–31) were ultimately included. The literature screening process is shown in Figure 1.

Among the 18 included articles, 2 were in Chinese (17, 19) and 16 in English (12, 15, 16, 18, 20–31).he included studies employed diverse methodological approaches. By primary study design, there were 5RCTs (15, 16, 24, 28, 31), 6 quasi-experimental studies (12, 17, 19, 20, 25, 26), 1 cohort study (29), and 6 studies that utilized a mixed-methods framework (18, 21–23, 27, 30). These mixed-methods studies integrated quantitative (e.g., surveys, outcome measures) and qualitative (e.g., interviews, focus groups) components to comprehensively evaluate the interventions. The basic characteristics of the included literature are presented in Table 1. In summary, the included studies, published between 2011 and 2025, originated from various countries (e.g., USA, Australia, Portugal, China, Austria) and employed a range of telemedicine modalities (apps, video platforms, integrated systems). Sample sizes were generally small to moderate. This diversity highlights the evolving and international nature of the field but also underscores the heterogeneity in intervention design and evaluation.

Telemedicine in home-based palliative care presents a pattern of diversified development. At the mobile application level, the Tap Cloud app integrated functions like symptom assessment, medication management, and real-time alerts (27). Dedicated device systems provided video consultation and physiological monitoring services via tablet devices pre-loaded with professional software (12). Intelligent integrated systems, leveraging platforms like We Chat Mini-Programs, incorporated AI analysis and automatic alert functions for personalized follow-up management (17). Specialty-specific platforms, such as those for neurological diseases, developed remote consultation systems with dual-network guarantees (24). Pain management applications established professional pain management systems through structured assessment and personalized education modules (16). These technological solutions demonstrate a complete developmental spectrum from general-purpose to specialized, and from basic functions to intelligent integration, offering diverse technical solutions for HBPC in different scenarios. In terms of service models, innovative developments have emerged, including the “clinic-to-home” hybrid care model (26), the “internet + offline service” integrated model (19), and disease-specific specialized service models (24). Regarding management strategies, a significant shift from standardization to personalization has been achieved. Demand-driven models (20) are gradually replacing fixed-frequency supply-driven models (28). Personalized management plans (16) and tiered alert systems (29) have enhanced service precision. Furthermore, the concept of integrated care has deepened. Multidisciplinary collaboration models (27), caregiver support systems (23), and comprehensive management systems (18) jointly construct a holistic remote palliative care service network. This diversified landscape reflects both the inclusivity and adaptability of technological applications and highlights a patient-needs-centered service philosophy, providing varied and practical solutions for home-based palliative care in different contexts.

The application of telemedicine demonstrates clear advantages, capable of overcoming time and space constraints, contributing to improved care quality and efficiency, and reducing healthcare costs (32). Regarding feasibility, multiple studies confirmed its potential for technical implementation and service delivery. Practice showed that integrating remote services into routine outpatient workflows could successfully establish a “clinic-to-home” continuous care model, proving its operability within existing healthcare systems (26). In terms of technology acceptance, mobile application-based remote systems were confirmed to have high usability and user acceptance. Users generally found them easy to operate, responsive, and effective in enhancing the efficiency and quality of care services (27). Even in environments with weak technological infrastructure, such as nursing homes, telemedicine could be accepted and used by different groups with appropriate technical support (22). Regarding effectiveness, telemedicine demonstrated multi-faceted clinical value, Future meta-analyses on this topic would benefit from careful consideration of appropriate effect size measures (e.g., standardized mean differences for continuous outcomes) and model selection (fixed vs. random effects), alongside reporting heterogeneity metrics (e.g., I² statistic) to better quantify and interpret the pooled evidence. Including symptom management, quality of life improvement, and psychological state enhancement. Research indicated that mobile app-based remote interventions could effectively alleviate patient symptoms such as pain, dyspnea, and depression, and significantly improve overall quality of life (27). Another study noted that although patients using a specific app might experience short-term fluctuations in emotional well-being, their overall quality of life still showed a positive improvement trend (18). Furthermore, remote support also demonstrated positive effects in providing psychological support and guidance, effectively reducing patients’ anxiety and depression levels and offering continuous emotional support (12). In terms of cost-effectiveness, telemedicine demonstrated significant benefits in reducing medical costs and optimizing resource allocation. Studies showed this model could substantially lower the direct financial burden on patient families (25). Through early symptom intervention and continuous monitoring, telemedicine significantly reduced unplanned emergency visits and hospitalizations due to worsening conditions (18, 20, 24, 26). This proactive health management approach not only avoided unnecessary medical expenditures but also improved the efficiency of healthcare resource utilization, allowing limited resources to serve the patients in greatest need more precisely, thereby achieving dual benefits at both individual and societal levels.

Currently, telemedicine, as a feasible and promising technology, has seen preliminary application in home-based palliative care patients. However, several constraining factors require attention and improvement.

Building on the synthesized evidence and identified challenges, the future development of telemedicine in HBPC should prioritize several areas, with particular adaptations needed for systems like China’s.

First, there is a pressing need for standardized yet adaptable service frameworks. This involves developing national guidelines that define core service components, technical standards, and quality metrics for tele-HBPC, while allowing for regional customization to address local resource disparities and patient needs. Second, addressing the workforce shortage is critical. This requires integrating competencies in both palliative care and telemedicine into the core curricula of medical and nursing education, alongside creating up skilling programs for existing healthcare professionals. Third, technology design and service delivery models must achieve cultural congruence. In family-centric societies like China, digital platforms should be designed to facilitate and empower family involvement in care coordination, communication, and decision-making, rather than aiming to replace the familial caregiving role. Fourth, equitable access must be ensured. Strategies should focus on improving digital infrastructure in underserved areas and providing tailored support to enhance digital literacy among older patients and their families, to prevent the widening of health disparities. Finally, sustainable financing models must be explored. Incorporating tele-HBPC into basic medical insurance schemes, allocating public health funds for pilot programs, and fostering public-private partnerships are potential pathways to ensure the long-term viability and accessibility of these services.