Thursday, 20 August 2015

Its good to Talk

Ehde DM, Elzea JL, Verrall AM, Gibbons LE, Smith A, Amtmann D. Efficacy of A Telephone-Delivered Self-Management Intervention For Persons With Multiple Sclerosis: a Randomized Controlled Trial With a One-Year Follow-Up. Arch Phys Med Rehabil. 2015. pii: S0003-9993(15)00647-4

OBJECTIVE:To evaluate the efficacy of a telephone-delivered self-management intervention for fatigue, pain, and depression in adults with multiple sclerosis (MS).
DESIGN:Single-center, randomized (1:1), single blind (outcome assessors) parallel-group trial with a primary end-point of post-treatment (9-11 weeks post-randomization) and long-term follow-ups at 6- and 12-months.
SETTING:Telephone-delivered across the United States.
PARTICIPANTS:Adults with MS (N=163) with fatigue, chronic pain, and/or moderate depressive symptoms (age range 25-76 years).
INTERVENTIONS: Eight-week individual telephone-delivered self-management intervention (T-SM: n=75) versus an eight-week individual telephone-delivered MS education intervention (T-ED: n=88).
MAIN OUTCOME MEASURES: The primary outcome was the proportion who achieved a > 50% decrease in one or more symptom - fatigue impact, pain interference, and/or depression severity. Secondary outcomes included continuous measures of pain, fatigue impact, depression, self-efficacy, activation, health-related quality of life, resilience, and affect.
RESULTS: For our primary outcome, 58% of those in the T-SM and 46% of those in the T-Ed had a > 50% reduction in one or more symptom; this difference was not statistically significant (OR: 1.50, 95% CI: 0.77 to 2.93, p = 0.238). Participants in both groups significantly improved from baseline to post-treatment in primary and secondary outcome measures (p < 0.05). T-SM participants reported significantly higher treatment satisfaction and therapeutic alliance and greater improvements in activation, positive affect, and social roles. Improvements were generally maintained at 6- and 12-months.
CONCLUSIONS: Both interventions resulted in short- and long-term, clinically meaningful benefits. The study demonstrated that the telephone is an effective method for engaging participants in and extending the reach of care for individuals with MS



I wonder if we will have the NHS working by telephone, would a ProgG webinar work wonders too?

3 comments:

  1. This blog is in the throes of silly season, it seems.

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  2. Telephone consultations are not necessarily the poor cousin of face-to-face appointments. I have often received advice from my current GP by telephone and there are significant advantages. Most importantly, it can be much easier to talk about intimate, sensitive issues on the telephone.

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    Replies
    1. Yes I agree Sterntaucher. I've used the 111 NHS non emergency phone number a few times and it has been valuable. I've got to speak to a nurse or paramedic, more oftenly a GP. I've also come across a few private healthcare companies that offer a similar service to 111.

      I've often thought a virtual MS nurse would be good, sykpe or telephone. My MS nurse if often away on leave or takes a week to answer messages. If my concern in this case is more urgent when she's on leave I am advised to see my GP. My GP doesn't have that much MS knowledge.

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