Collaborative care led by a nurse-physician team with web-based self-management better than self-management alone
FRIDAY, July 26, 2019 (HealthDay News) — Online symptom self-management plus clinician telecare can be effective for individuals with pain, depression, and anxiety, according to a study recently published in the Journal of General Internal Medicine.
Kurt Kroenke, M.D., from Indiana University in Indianapolis, and colleagues evaluated the effectiveness of automated self-management (ASM; automated monitoring and nine web-based self-management modules) versus comprehensive symptom management (CSM; ASM with enhanced collaborative care by a nurse-physician team). Analysis included 294 patients with chronic musculoskeletal pain of at least moderate intensity and clinically significant depressive and/or anxiety symptoms who were seen in six primary care clinics in a U.S. Department of Veterans Affairs medical center.
The researchers found that both CSM and ASM groups had moderate pain-anxiety-depression (PAD) score improvement at 12 months. The CSM group had a greater decline in composite PAD z-score over 12 months compared to the ASM group. Additionally, CSM patients were also more likely to report global improvement and less likely to report worsening at both six and 12 months.
“Two intervention models relying heavily on telecare delivery but differing in resource intensity both produced moderate improvements in pain and mood symptoms,” the authors write.
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