Abstract:
STUDY DESIGN:Single-blind randomized controlled trial of 6 months' duration. OBJECTIVES:To evaluate the efficacy of a novel telehealth intervention, 'CareCall', on reducing pressure ulcers and depression and enhancing the use of appropriate health care. SETTING:General community, Massachusetts and Connecticut, United States METHODS:'CareCall' is an automated, interactive voice response system that combines patient education, cognitive behavioral interventions, screening and referrals, with alerts to a nurse telerehabilitation coordinator for direct non-emergent phone follow up. Participants consisted of a convenience sample of 142 persons with multiple sclerosis or spinal cord injury using a wheelchair >6 h per day. The intervention group received CareCall (n=71) The control group received usual care (n=71). The main outcome measures were: The pressure ulcer scale for healing tool, Patient Health Questionnaire-9 depression scale, Cornell Services Index and Craig Hospital Inventory of Environmental Factors-Short Form Question 5. RESULTS:CareCall achieved a reduction in presence of pressure ulcers at 6 months in women (P<0.0001). Among those with baseline depression, CareCall reduced 6-month severity of depression, adjusting for age and gender (P<0.047). CareCall did not have a significant impact on health-care utilization (OR=1.8, P=0.07), but did significantly improve participants' report of health-care availability (OR=2.03, P<0.04). CONCLUSION:This is the first study to demonstrate the efficacy of a largely automated telehealth intervention for adults with spinal cord dysfunction. Future research needs to replicate this study in a larger, multisite trial.
journal_name
Spinal Cordjournal_title
Spinal cordauthors
Houlihan BV,Jette A,Friedman RH,Paasche-Orlow M,Ni P,Wierbicky J,Williams K,Ducharme S,Zazula J,Cuevas P,Rosenblum D,Williams Sdoi
10.1038/sc.2013.45subject
Has Abstractpub_date
2013-09-01 00:00:00pages
715-20issue
9eissn
1362-4393issn
1476-5624pii
sc201345journal_volume
51pub_type
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