Telehealth Palliative Care for Chronic Obstructive Pulmonary Disease in Iran: The Study Protocol of a Randomized Controlled Feasibility Trial Publisher



Arabi Z ; Mirshahi A ; Kazemi Zadeh H ; Haghani S ; Iyer A ; Wells R ; Bakitas M ; Shahmari M ; Manookian A
Source: Journal of Research Development in Nursing and Midwifery Published:2025

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive, irreversible respiratory condition that imposes a significant physical and psychological burden, often leading to a poor quality of life. Although palliative care can help address these challenges, in Iran it is typically limited to cancer patients and is not commonly provided to those with COPD. Globally, the early integration of palliative care for chronic illnesses is expanding. The present study aims to investigate the feasibility and acceptability of an early tele-palliative care intervention for patients with COPD in Iran and to explore its potential effects on quality of life, anxiety, depression, and emergency department readmissions. Methods: This randomized controlled feasibility trial protocol involves a 3-month early tele-palliative care program delivered by two nurse coaches, targeting patients with COPD. Participants were randomly assigned to either the intervention group (n = 26) or the control group (n = 26) using permuted block randomization. Both groups received traditional COPD care; however, the intervention group also received six weekly telephone sessions and six weeks of follow-up support via phone call and WhatsApp Messenger. The primary objective was to assess the feasibility and acceptability of early tele-palliative care, measured through recruitment and attrition rates, questionnaire completion rates, patient satisfaction, attitudes toward the intervention, and adherence to the intervention. The secondary outcome included changes in quality of life, anxiety, depression, and hospital readmissions. These were measured using validated instruments at two time points: Baseline (Pre-intervention) and three months post-intervention. Statistical analyses were performed using SPSS version 22, including the independent samples t-test, paired samples t-test, chi-square test, and Fisher’s exact test. Analysis of covariance (ANCOVA) was used to compare the mean outcomes between the two groups while statistically controlling for the effect of baseline values. Statistical significance was set at p < 0.05. Conclusion: This study protocol aimed to determine the feasibility and acceptability of an early tele-palliative care intervention for patients with COPD in Iran. The findings provided essential data to inform the design of a future large-scale clinical trial and support the potential integration of early telehealth palliative care into standard COPD management in the country. © 2025, Golestan University of Medical Sciences. All rights reserved.