Telephone-Based Care helps Cancer pain and depression

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According to a study in the July 14 issue of the Journal of American Medical Association (JAMA), cancer patients showed improvement in pain and depression when using a telephone-based care management program over those who received the usual care.

Kurt Kroenke, M.D. of the Richard Roudebush VA Medical Center, Indiana University, and Regenstrief Institute, Indianapolis, along with colleagues conducted the trial, “Indiana Cancer Pain and Depression (INCPAD) within “16 community-based urban and rural geographically dispersed oncology practices.”
Pain and depression are the most common symptoms in cancer patients and yet often go undetected and untreated making cancer more debilitating. The study was conducted from March 2006 through August 2008, with follow-up done in August of 2009. The participants had depression, cancer-related pain or both and were assigned randomly to two groups: the telephone program (n = 202) or usual care (n = 203), and were further categorized by symptom type.

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Along with a telecare management system used by a nurse-physician team, the treatment group also received in home symptom monitoring by an automatic interactive voice recording or Internet. The nurse care managed was trained in “assessing symptom response and medication adherence; providing pain and depression-specific education; and in making treatment adjustments according to evidence-based guidelines.” These symptoms were assessed throughout the course of the study.

The study found that out of 274 patients with pain, 137 had great improvements in pain than those in the control group. Those in the study with depression showed similar improvement in the treatment group over those in the control group. The intervention group also showed improvement in other areas including mental health, vitality, anxiety, and physical symptom burden.

This study spells good news for cancer patients who often feel little relief of symptoms during their treatment, especially if they do not have the support of family and friends. Cancer is a life-threatening disease and these patients need the support that a telecare program can provide, even for those who have a support system in place.

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