Tele-Palliative Care in Rural Areas, Implementation and Patient Experiences: A Systematic Review

BackgroundSpecialist palliative care remains highly uneven in rural and remote settings for patients with life-limiting illness and their families. This review aimed to examine the implementation characteristics, clinical and service-level outcomes, and patient experiences of tele-palliative care interventions for individuals living in rural or remote settings with limited access to specialist palliative care.MethodsA systematic review was conducted in accordance with the PRISMA 2020 guidelines across PubMed, Scopus, CINAHL, and Google Scholar (August-October 2025). Eligible studies were published within the past 20 years and evaluated tele-palliative care interventions among rural populations. Data were extracted and outcomes were narratively synthesized.ResultsThirteen primary studies were included, conducted in the United States (n = 8), Australia (n = 2), Canada (n = 1), Japan (n = 1), and England (n = 1). Interventions included video consultations, hybrid tele-palliative programs, and remote symptom monitoring. Across studies, reported outcomes included implementation and process outcomes, patient and caregiver experiences and communication outcomes, clinical and care-process outcomes and health service utilization and economic outcomes. Challenges included technological instability, internet access limitations and inconsistent implementation fidelity.ConclusionsTele-palliative care can extend specialist palliative care to rural and remote communities by reducing travel burden and supporting continuity, particularly when delivered through hybrid models embedded in local care pathways. However, the evidence base remains limited and concentrated in high-income settings, with heterogeneity in intervention models and outcome reporting. Future studies should use standardized implementation outcomes, evaluate equity impacts, and compare hybrid tele-palliative models with usual care in diverse rural contexts.