Palliative telecare provides lasting quality of life improvements for chronically ill patients

Researchers from the University of Colorado Anschutz Medical Campus have found that a team intervention, provided by phone, leads to persistent improvements in depression, anxiety, and quality of life for people managing chronic illnesses. Additionally, researchers found that the improvement in quality of life results last months after intervention concludes.

In a study, published today in JAMA, researchers observe the impact a telecare intervention program, called ADAPT, has on veterans suffering from poor quality of life as a result of existing chronic illnesses, such as chronic obstructive pulmonary disease (COPD), heart failure (HF) and interstitial lung disease (ILD). This program provides palliative care that is not widely available and tackles health concerns that may be missed in standard appointments. Nurses and social workers reach out to study participants with structured questions and assistance, then discuss responses with a team of doctors, including specialists, to determine how best to address concerns with follow-up calls to track progress.

While we do a great job caring for these patients' illnesses, we can do more for quality of life. Many have persistent symptoms, such as depression, anxiety, shortness of breath, and sleep problems that can make living with these illnesses very difficult and have been associated with earlier death. Palliative care can help. However, access to outpatient palliative care specialists is limited to non-existent, and new, scalable ways to provide early palliative care are needed."

David Bekelman, MD, MPH, professor at the University of Colorado School of Medicine and study lead author

For adults with COPD, HF or ILD at high risk of hospitalization and death and poor quality of life, this program demonstrated early, persistent and clinically meaningful improvements in depression, anxiety, and quality of life. Additionally, while ADAPT lasted for 4 months, Bekelman and researchers saw positive results early that lasted for many months after the program ended.

"There are people who endure persistent symptoms and poor quality of life despite great treatments. We need to fill in the gaps and provide more for these patients," says Bekelman who worked with the VA of Eastern Colorado Puget Sound Health Care Systems to conduct this research to conduct this research. "This innovative team care model is adaptable, scalable and can help make life better for people living with these illnesses. This program demonstrates that even a short amount of time providing structured telecare results in increased quality of life months after the calls end."