The use of telemedicine in palliative care in low- and middle-income countries: A scoping review

Background: Telemedicine may improve access and delivery of palliative care in low and middle-income countries (LMICs). Despite increasing adoption and diverse applications, there is limited understanding of their use in palliative care. Aim: Determine the challenges, enablers and key characteristics of telemedicine interventions targeting outcomes delivered in palliative care in LMICs. Design: A scoping review guided by the JBI methodology. Data sources: Six databases (MEDLINE, EMBASE, PsycInfo, Global Health, CINAHL and IEEE Xplore) were searched for reports published between 2003 and August 2025. WHO IRIS and clinical trial registries were searched in March 2026. Forward and backward citation searching was also conducted. Results: Of the 7938 reports identified from database searches, 21 met the inclusion criteria. Additional searches of WHO IRIS and clinical trial registries did not identify any additional reports. Most interventions focused on telemonitoring (n = 14), commonly delivered via telephone (n = 8) and involving a doctor/clinician (n = 8). Four studies measured only objective levels of engagement, one study assessed only subjective engagement, while three studies measured both objective and subjective engagement, but the measures used across these studies were heterogeneous. Three studies identified challenges to engaging with telemedicine interventions, including poor digital literacy, lack of a physical exam, and poor internet connectivity. Conclusions: Telemedicine demonstrates emerging, context-specific potential to support access to palliative care in LMICs, although the current evidence base is limited and concentrated in middle-income and cancer-focused settings. Future research should adopt theoretically informed, system-integrated approaches with consistent evaluation to ensure equitable and sustainable delivery.