A new study indicates that programs that include home-based automated symptom monitoring and telephone-based care management improve cancer patients’ ability to cope with pain and depression.
The “Indiana Cancer Pain and Depression Trial” (INCPAD) included patients in 16 community-based urban and rural cancer practices. Of the 405 participants, 202 patients were assigned to the intervention program and 203 received usual care; 131 had depression only, 96 had pain only, and 178 reported having both depression and pain.
Half of the participating patients received automated home-based symptom monitoring by interactive voice recording or Internet. They were also monitored by a centralized home telecare system managed by a nurse-physician specialist team. The patients were assessed for signs of depression and pain symptoms at the start of the study, and then again at one, three, six and 12 months.
After 12 months, the 137 patients with pain in the intervention group showed greater improvement in pain symptoms than the 137 patients with pain and receiving standard care. The 154 patients with depression in the intervention group had significantly greater improvement in depression severity than the 155 patients with depression in the usual-care group. The report appeared in the July 14 issue of the Journal of the American Medical Association.
Dr. Kurt Kroenke, of the Richard Roudebush VA Medical Center, Indiana University, and Regenstrief Institute in Indianapolis, said the trial demonstrated that it is feasible to provide telephone-based centralized symptom management across multiple, geographically-dispersed, community-based practices in both urban and rural areas by coupling human interactions with technology-assisted patient interactions.
He added that the study’s findings did not appear to be confounded by differential rates of co-interventions or health care use.
“The fact that INCPAD was beneficial for the most common physical and psychological symptoms in cancer patients demonstrates that a collaborative care intervention can cover several conditions, both physical and psychological,” the researchers concluded.
