• Posted January 19, 2024

Palliative Care Works, Even When Delivered By Phone

Folks with life-threatening chronic illnesses can receive effective support over the telephone as they manage their condition day by day, a new clinical trial finds.

Seriously ill veterans living with lung or heart disease experienced significant improvements in depression, anxiety and quality of life from a palliative care program delivered by phone, researchers found.

“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,” said study lead author Dr. David Bekelman, a professor at the University of Colorado School of Medicine.

“Palliative care can help,” Bekelman added in a university news release. “However, access to outpatient palliative care specialists is limited to non-existent, and new, scalable ways to provide early palliative care are needed.”

For this study, Bekelman and his colleagues provided telephone-based counseling to half of a group of 306 patients in two Veterans Administration health care systems, located in Colorado and Washington.

The patients had one of three chronic illnesses, weren't being treated in a hospital and all had a high risk of death and poor quality of life, researchers said. The illnesses were chronic obstructive pulmonary disease (COPD), heart failure and interstitial lung disease.

Patients assigned to one group got 12 counseling phone calls over a four-month period -- six calls with a nurse to help with symptom management and six calls with a social worker to provide therapy and support.

The nurse and social worker met regularly with a primary care and palliative care physician to review each patient's condition and determine how to best address their concerns. They also had access to a cardiologist or pulmonologist as needed.

In this way, the program provided supportive care that's not widely available, as well as tackling health concerns that might be missed in regular doctor's visits, researchers said.

People in the other group got an educational handout that outlined self-care for their chronic illness.

By six months, quality of life for patients in the counseling group had improved significantly more than for patients in the control group.

Those who received phone counseling also experienced improvements in depression, anxiety and the status of their COPD or heart failure.

Bekelman said that the positive results from the program lasted for many months after the program ended.

The study was published Jan. 16 in the Journal of the American Medical Association.

“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,” Bekelman said.

“This innovative team care model is adaptable, scalable and can help make life better for people living with these illnesses,” he added. “This program demonstrates that even a short amount of time providing structured telecare results in increased quality of life months after the calls end.”

More information

The National Institutes of Health has more about coping with a chronic illness.

SOURCE: University of Colorado, news release, Jan. 16, 2024