Bonnie Kenaley, faculty in Boise State University’s School of Social Work, and Zvi Gellis, a faculty collaborator from the Center for Mental Health and Aging at the University of Pennsylvania, have published a manuscript titled “Integrated Telehealth Care for Chronic Illness and Depression in Geriatric Home Care Patients: The Integrated Telehealth Education and Activation of Mood (I-TEAM) Study” in the Journal of the American Geriatrics Society. Thomas Ten Have, now deceased, from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania is the third author of the paper.
The paper describes the results of a study of I-TEAM’s effectiveness. I-TEAM is an integrated telehealth intervention to improve chronic illnesses, such as congestive heart failure and chronic obstructive pulmonary disease (COPD), and comorbid depression in home healthcare settings. The US Department of Health and Human Services defines telehealth as “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include video conferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.”
The I-TEAM intervention was used for three months and consisted of integrated telehealth chronic illness and depression care, with a telehealth nurse conducting daily telemonitoring of symptoms, body weight and medication use. Additionally, the telehealth nurse provided eight weekly sessions of problem-solving treatment for depression and communicated with participants’ primary care physicians, who had prescribed the antidepressants. In contrast, a control group of participants were allocated to the usual care with in-home nursing plus psychoeducation.
The groups were compared prior to the intervention and then three and six months later with their depression, health and problem-solving, and again 12 months after the start of the intervention with readmission, episodes of care and emergency department visits. The researchers found that the depression scores for the I-TEAM group were 50 percent less than the control group at the three and six month marks. The I-TEAM group had significantly fewer emergency department visits, and showed a trend toward fewer days in the hospital a year after beginning the intervention.
Kenaley and Gellis have been working together on telehealth since 2006.