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J Am Geriatr Soc. 2014 May;62(5):889-95. doi: 10.1111/jgs.12776. Epub 2014 Mar 21.

Integrated telehealth care for chronic illness and depression in geriatric home care patients: the Integrated Telehealth Education and Activation of Mood (I-TEAM) study.

Author information

1
Center for Mental Health and Aging, School of Social Policy and Practice, University of Pennsylvania, Philadelphia, Pennsylvania.

Abstract

OBJECTIVES:

To evaluate an integrated telehealth intervention (Integrated Telehealth Education and Activation of Mood (I-TEAM)) to improve chronic illness (congestive heart failure, chronic obstructive pulmonary disease) and comorbid depression in the home healthcare setting.

DESIGN:

Randomized controlled trial.

SETTING:

Hospital-affiliated home healthcare setting.

PARTICIPANTS:

Medically frail older homebound individuals (N = 102).

INTERVENTION:

The 3-month intervention consisted of integrated telehealth chronic illness and depression care, with a telehealth nurse conducting daily telemonitoring of symptoms, body weight, and medication use; providing eight weekly sessions of problem-solving treatment for depression; and providing for communication with participants' primary care physicians, who also prescribed antidepressants. Control participants were allocated to usual care with in-home nursing plus psychoeducation (UC+P).

MEASUREMENTS:

The two groups were compared at baseline and 3 and 6 months after baseline on clinical measures (depression, health, problem-solving) and 12 months after baseline on health utilization (readmission, episodes of care, and emergency department (ED) visits).

RESULTS:

Depression scores were 50% lower in the I-TEAM group than in the UC+P group at 3 and 6 months. Those who received the I-TEAM intervention significantly improved their problem-solving skills and self-efficacy in managing their medical condition. The I-TEAM group had significantly fewer ED visits (P = .01) but did not have significantly fewer days in the hospital at 12 months after baseline.

CONCLUSION:

Integrated telehealth care for older adults with chronic illness and comorbid depression can reduce symptoms and postdischarge ED use in home health settings.

KEYWORDS:

depression; home care; integrated care; randomized trial; telehealth

PMID:
24655228
DOI:
10.1111/jgs.12776
[Indexed for MEDLINE]

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