A new paper was released yesterday from the Annals of Internal Medicine that caught my eye: Telephone-Based Self-management of Osteoarthritis.
This randomized trial assigned primary care patients with hip or knee osteoarthritis to receive telephone-based health education support, health education materials, or usual care. At 12 months, the intervention group had more improvement in some pain measures than did the control groups.
The paper’s findings are not so surprising to those who have ever had a positive experience with a knowledgable health care provider: talking over a problem and receiving encouragment from an expert helps motivate you to stick to a care plan. But the results aren’t exactly what grabbed me.
Take this recent Lancet Neurology editorial, “Neurology at a distance,” for example. The author states: “The provision of clinical care via a communication system is nothing new, but advances in communication technologies and computing are bringing new and exciting innovations into the realm of remote medicine. The day of modern telemedicine is dawning.” This is certainly true, and the exiciting advancements that video calling, webcams, iPhones and iPads are having on remote clinical delivery are real and beneficial.
But in this article, what was the intervention that helped manage the pain in osteoarthritis patients? A phone call. As in, two people talking to one another. Well, there was also some educational materials and video involved, but here’s the meat:
The health educator called participants monthly for 12 months to discuss key points from the educational modules and provide participants with an opportunity to ask questions.
Just something to keep in mind the next time you pick up your smartphone and launch Epocrates. The thing’s still a phone, you know.
Allen, Kelli D., Oddone, Eugene Z., Coffman, Cynthia J., Datta, Santanu K., Juntilla, Karen A., Lindquist, Jennifer H.,Walker, Tessa A., Weinberger, Morris and Bosworth, Hayden B. Telephone-Based Self-management of Osteoarthritis: A Randomized Trial. Ann Intern Med. 2010 Nov;153:570-579.
PS: for those of you doing telemedicine literature reviews in MEDLINE, don’t forget about EMBASE and CINAHL… you might be missing 9 – 18% of the relevant citations.