A pilot study of a telehealth intervention for persons with spinal cord dysfunction

作者：Houlihan B V^*; Jette A; Friedman R H; Paasche Orlow M; Ni P; Wierbicky J; Williams K; Ducharme S; Zazula J; Cuevas P; Rosenblum D; Williams S

来源：Spinal Cord, 2013, 51(9): 715-720.

DOI：10.1038/sc.2013.45

• spinal cord injuries
• multiple sclerosis
• telemedicine
• pressure ulcer
• depression
• controlled clinical trial

Study design: Single-blind randomized controlled trial of 6 months%26apos; duration. %26lt;br%26gt;Objectives: To evaluate the efficacy of a novel telehealth intervention, %26apos;CareCall%26apos;, on reducing pressure ulcers and depression and enhancing the use of appropriate health care. %26lt;br%26gt;Setting: General community, Massachusetts and Connecticut, United States %26lt;br%26gt;Methods: %26apos;CareCall%26apos; 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 %26gt;6h 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. %26lt;br%26gt;Results: CareCall achieved a reduction in presence of pressure ulcers at 6 months in women (P%26lt;0.0001). Among those with baseline depression, CareCall reduced 6-month severity of depression, adjusting for age and gender (P%26lt;0.047). CareCall did not have a significant impact on health-care utilization (OR=1.8, P=0.07), but did significantly improve participants%26apos; report of health-care availability (OR=2.03, P%26lt;0.04). %26lt;br%26gt;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.

• 出版日期2013-9