Telemedicine in Palliative Care: A Systematic Review and Meta-Analysis of Quality of Life, Symptom Control, and Healthcare Utilisation, with Exploratory Analysis of Artificial Intelligence

Background:Palliative care access remains limited globally, with fewer than 14% of patients receiving adequate services. Telemedicine has emerged as a potential solution to address structural barriers. Methods:A systematic review and meta-analysis of studies published between 2015 and 2025 was conducted. Pooled analyses were restricted to randomized controlled trials (RCTs), while other study designs were included for narrative synthesis. Results:Fifty-two studies (~14,200 patients) were included; pooled analyses were restricted to 18 RCTs. Telemedicine significantly improved quality of life (SMD 0.29, 95% CI 0.11–0.47). Symptom burden (SMD −0.27) and caregiver burden (SMD −0.22) were reduced, and emergency department visits decreased (RR 0.68). AI models demonstrated good predictive performance but lacked prospective validation. Conclusion:Telemedicine improves key clinical outcomes in palliative care and represents a scalable solution to current access limitations. AI applications remain investigational and require prospective validation. Keywords: palliative care; telemedicine; telehealth; digital health; meta-analysis; artificial intelligence