14 July 2010

Intervention May Help Relieve Cancer Patients' Pain, Depression

Combining high-tech and human interaction yielded psychological, physical benefits, study found

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TUESDAY, July 13 (HealthDay News) -- Cancer patients' ability to cope with pain and depression was improved through a program that included home-based automated symptom monitoring and telephone-based care management, a new study has found.

The study, called the Indiana Cancer Pain and Depression (INCPAD) trial, included patients in 16 community-based urban and rural cancer practices -- 202 patients were assigned to the intervention program and 203 received usual care. Of the 405 patients, 131 had depression only, 96 had pain only, and 178 had both depression and pain.

The patients in the intervention group received automated home-based symptom monitoring by interactive voice recording or Internet, and centralized telecare management 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 in the usual-care group. 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, according to the report published in the July 14 issue of the Journal of the American Medical Association.

There were a number of important findings from the INCPAD trial, said Dr. Kurt Kroenke, of the Richard Roudebush VA Medical Center, Indiana University, and Regenstrief Institute in Indianapolis, and colleagues.

"First, the telecare management intervention resulted in significant improvements in both pain and depression. Second, 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 with technology-augmented patient interactions. Third, the findings did not appear to be confounded by differential rates of co-interventions or health care use," the study authors wrote in their report.

"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.

More information

The U.S. National Cancer Institute has more about cancer and depression.


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