Commentary

Palliative Care in the Comfort of Home


 

Meet the Health Buddy, a telehealth technology intervention that significantly improved the symptoms and quality of life for head and neck cancer patients in a randomized trial by delivering symptom management in the comfort of the patient’s home, computer not required.

Cynthia Ellis Keeney, RN, MSN, couldn’t contain her excitement as she presented her group’s study findings in a poster session at a palliative care summit in Bethesda, Md. The meeting was sponsored by the National Institute of Nursing Research and partner organizations.

Photo credit: Courtesy of Wikimedia Commons user Arglos, collected via GNU Free Documentation License

Head and neck cancer patients suffer terribly from a range of symptoms, and they often find it difficult to talk and uncomfortable to leave the house, said Ms. Keeney.

She and her colleagues randomized 80 newly diagnosed head and neck cancer patients to an intervention with a telehealth device or usual care. The telehealth device was connected to a landline phone and featured a small screen with large buttons.

The device allowed patients with limited computer savvy and no internet access to benefit from the convenience of the telehealth intervention, Ms. Keeney emphasized.

Each day, a green light on the Health Buddy would blink, prompting patients to respond to questions about how they were feeling that day. Based on their answers, the system would recommend an intervention, such as asking the doctor for a drug to treat a particular symptom (for example, constipation). Symptom control algorithms had been used to generate questions based on symptoms that are most likely to occur during the active phase of cancer treatment. The phone number of the patient’s doctor had been programmed into the system for immediate access.

After the active phase of their cancer treatments, patients in the Health Buddy group reported significantly higher physical well being than did controls.

Although the doctors and patients weren’t connected visually in real time, the patients felt that being able to define their symptoms through the Health Buddy and receive suggestions for symptom management allowed them to have better conversations with their doctors, Ms. Keeney said. As a result, “the patients in the intervention group thought they got better care,” than if they had not used the Health Buddy, she added.

–Heidi Splete (on Twitter @hsplete)

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